in good The Hernia Doctor
September 2017 • Issue 145
Hernia repair surgeon Joseph A. Talarico helps Thompson Health become a Hernia Center of Excellence, the first of its type in New York state
Rochester’s Healthcare Newspaper
Call it beer belly, love handles, spare tire: doctors say men with large bellies have increased risk of death by various associated diseases. Find out what they can do to address the problem. See Men’s Health Special inside
Depending on your job, you’re more likely to suffer from it
Eye Drops to Cure Cataracts?
Fun Ways to Get Fit This Fall One of the many events in September: A tour through Mt. Hope Cemetery to explore its geology. See inside for more options
Scientists are still testing using eye drops to dissolve cataracts in humans; in the meantime, new techniques to remove them are available
Protecting Chronically Ill Young People
4 Reasons to Eat Sesame Seeds it’s time to say “open sesame” to all that makes this small seed so big on nutritional benefits.
800,000 That’s the number of Americans who receive medical care for dog bites annually
Teach your preschooler more than just their ABCs.
Teach them compassion.
At CP Rochester and Happiness House your preschooler... will be given three unique gifts... the gifts of understanding, kindness, and compassion toward children who may be different from themselves. Each child who attends our preschools, regardless of their abilities, receives top-notch instruction from licensed or certified instructors. Therapy is provided for students in their least restrictive environment. Gym and playtime are regular parts of every student’s experience. Together, the students build relationships and develop skills that will enhance their kindergarten readiness. Give your preschooler the very best early education they deserve. One that will prepare them to be the young people you want them to be. Call for a tour. 2017 Program begins on September 7th!
Geneva Canandaigua Henrietta 315-789-6850 585-394-1190 585-334-6000
IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • September 2017
Teach your presc more than just th
At Happiness House and CP Rochester yo will be given three unique gifts... the gift kindness, and compassion toward childr different from themselves.
Each child who attends our preschools, r abilities, receives top-notch instruction f certified instructors. Therapy is provided least restrictive environment. Gym and p parts of every student’s experience. Toge build relationships and develop skills tha kindergarten readiness.
Opening Doors, GiveEnriching your preschooler the very best earl Lives... deserve. One that will prepare them to b you want to be. Call for a tour. Sothem That What Happens 2017 Program beginsHere on September 7th Changes Lives Geneva 315-789-6850 Canandaigua 585-394-1190 Forever Henrietta 585-334-6000
Americans Taking More Prescription Drugs Than Ever: Survey Consumer Reports says many may be doing more harm than good
new survey finds 55 percent of Americans regularly take a prescription medicine — and they’re taking more than ever. Those who use a prescription drug take four, on average, and many also take over-the-counter drugs, vitamins and other dietary supplements, the survey done by Consumer Reports shows. But many of those pills may be unnecessary and might do more harm than good, according to a special report in the September issue of Consumer Reports magazine. Among those who take prescription drugs, 53 percent get them from more than one health care provider, which increases the risk of adverse drug effects. More than a third say no provider has reviewed their medicines to see if all are necessary. Forty-nine percent of survey respondents who regularly take prescription medicine asked their prescribers whether they could stop taking a drug, and 71 percent were able to eliminate at least one. “We can see that when consumers ask if they can stop taking at least
one of their medications, in the majority of cases, their doctors agree,” Ellen Kunes, leader of Consumer Report’s Health and Food Content Development Team, said in a news release. The survey included almost 2,000 adults. The number of prescriptions filled for American adults and children rose 85 percent between 1997 and 2016, from 2.4 billion to 4.5 billion a year, according to the health research firm Quintile IMS. During that time, the U.S. population rose 21 percent. In 2014, nearly 1.3 million people sought emergency room treatment for adverse drug effects, and about 124,000 people died, according to U.S. government data cited by Consumer Reports. The article lists 12 conditions for which people can attempt lifestyle changes before taking prescription medications: ADHD; back and joint pain; dementia; mild depression; heartburn; insomnia; low testosterone; osteopenia (bone loss); overactive bladder; prediabetes; prehypertension, and obesity.
Rochester Gets Grant to Support Spay & Neuter Program Mayor Lovely A. Warren announced last month that Rochester Animal Services has been awarded a grant of $25,000 from the New York State Animal Population Control Program, which is administered by the American Society for the Prevention of Cruelty to Animals (ASPCA). “Animal shelters and animal control agencies are inundated with homeless strays and unwanted cats and dogs,” said Mayor Warren. “This grant will help us continue to support pet sterilization for low-income families throughout our community thereby helping support pet retention and reduce shelter intake of stray and unwanted pets.”
Rochester Animal Services has a spay-neuter voucher program to help support the sterilization of pets throughout Rochester’s underserved neighborhoods. Through that program, vouchers are provided to pet owners who may redeem them for spay and neuter surgeries at the Rochester Community Animal Clinic. Pet owners are responsible for a $1 co-pay and the grant covers the balance for the pet’s spay or neuter surgery. For more information about Rochester Animal Services, visit www.cityofrochester.gov/rochesteranimalservices.
Serving Monroe and Ontario Counties in good A monthly newspaper published
Health Rochester–GV Healthcare Newspaper
by Local News, Inc. Distribution: 33,500 copies throughout more than 1,500 high-traffic locations.
In Good Health is published 12 times a year by Local News, Inc. © 2017 by Local News, Inc. All rights reserved. 154 Cobblestone Court Dr., Suite 121 – P.O. Box 525, Victor NY 14564. • Phone: 585-421-8109 • Email: Editor@GVhealthnews.com Editor & Publisher: Wagner Dotto • Associate Editor: Lou Sorendo Writers: Jim Miller, Deborah J. Sergeant, Gwenn Voelckers, Anne Palumbo, Chris Motola, George W. Chapman, Ernst Lamothe Jr., Kyra Mancine, Diane Kane, MD • Advertising: Anne Westcott, Denise Ruf • Layout & Design: Dylon Clew-Thomas • Office Assistant: Kimberley Tyler No material may be reproduced in whole or in part from this publication without the express written permission of the publisher. The information in this publication is intended to complement—not to take the place of—the recommendations of your health provider. Consult your physician before making major changes in your lifestyle or health care regimen.
September 2017 •
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drleila.com IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper
HEALTH EVENTS T
Chairperson, HLAA National Board of Trustees
First VegFest to feature speakers, vendors
Rochester monthly program meetings
When: Sept 12, 2017, 2 Sessions: Noon: “HLAA: Relevant in a Changing Technological World” 8:00 PM: “The Invisible Veteran with Hearing Loss”
Where: St. Paul’s Episcopal Church East Avenue & Westminster Road, Rochester, NY 14610, across from the George Eastman Museum Free parking is available at the George Eastman Museum For more info visit hlaa-rochester-ny.org or call 585.266.7890 An induction hearing loop and captions will be used. The Hearing Loss Association of America opens the world of communication to people with hearing loss through information, education, support and advocacy.
Rochester VegFest will hold its very first event from 10 a.m. to 6 p.m., Sept. 16 at Dr. Martin Luther King Jr. Memorial Park at Manhattan Square, 353 Court St., Rochester. According to the organizers, Rochester has a large and growing population of enthusiastic vegans and this event is highly anticipated. Rochester VegFest will feature more than 30 exhibitors, food from local vegan restaurants, local vegan chefs, activities for kids, free yoga, delicious food samples, compassionate shopping, dynamic speakers and a free screening of the critically-acclaimed documentary “What the Health”, followed by a Q&A session. Some of the speakers include physician Tom Campbell, medical director of the T. Colin Campbell Center for Nutrition Studies;Torre Washington, award-winning vegan body builder, trainer, athlete and animal lover; Jo-Anne McArthur, author, photographer and animal rights activist; physician Ted Barnett with Rochester Lifestyle Medicine; Ian Cramer, the plant-based cyclist, and others. For more information, go to https:// rocvegfest.org/ or go to Facebook and type Rochester VegFest.
Volunteers Needed Research Waterpipe or Hookah User/Smoker?
Earn $100 by participating in our study! Waterpipe/Hookah Study Two visits ($50 per visit)- anytime 3-4 weeks apart from the first visit for blood draws (two teaspoons) and urine collection You may be eligible if: l You are between the ages of 21-65 years l You have been using Waterpipe/Hookah only or smoking cigarettes only, or smoking cigarettes and waterpipe/hookah together (dual use)
our Research Coordinator on (585) 273-2843 if you are interested or if you have any questions. Thank you! Page 4
Lifespan offers variety of free classes
Back pain to be discussed at Central Library Lesley Johnson, a nurse practitioner from University of Rochester Medical Center, will present “Oh, My Aching Back! Information, tips and treatment for back pain” from 12:10 to 12:50 p.m., Sept. 21 in the Kate Gleason Auditorium at the Central Library, 115 South Ave, Rochester. Parking is available in the Court Street garage, which is connected to the library. There will be healthy snacks and a free raffle. To request specific accommodations, call 585428-8304 10 days prior to the program. Sponsored by the Center for Community Health in partnership with the Central Library of Rochester and Monroe County, as part of the “Got Health” series. The talk will be streamed live by the Central Library, so those who can’t attend can tune in on Facebook. Please ‘like’ and ‘share’ the broadcast to help organizers spread the word.
Hearing loss group presents four programs Hearing Loss Association of America Rochester Chapter invites anyone interested in hearing loss to any or all of a full day of events on Tuesday, Oct. 3. All programs are held at St. Paul’s Episcopal Church, East Avenue at Westminster Road, Rochester, across from the George Eastman Museum. • 10 to 11:15 a.m. Hearing Other People’s Experiences (HOPE) in the
Church Vestry Room. At this round table discussion group, prospective or new hearing aid users can share their experiences and questions. Retired audiologist Joseph Kozelsky facilitates. • 11 a.m. to 1 p.m. Device Demonstration Center with Charlie Johnston and Dan Brooks. As a new community service, HLAA will offer a “Device Demonstration Center” once a month at the Lifespan headquarters on South Clinton Avenue. This presentation introduces the center and its new role. Hearing aids and cochlear implants are wonderful, but by themselves they can fall short of replacing “normal” hearing. At the demonstration center, people can try out an assortment of aids that could augment their communication abilities. Johnstone was the resource person for computer and presentation equipment until he retired from NTID. Brooks is an agent for New York Life Insurance Co. Both serve on the HLAA technology committee. 1:15-2 p.m. Cochlear Implant Subgroup in the East Room. Anyone considering or using cochlear implants is invited to join an informal discussion with experienced users who will share their experiences and answer questions about the surgery and audiology. Cochlear implants are prosthetic devices for people who can no longer benefit from hearing aids. For more information contact Ginger Graham at ggraham859@ gmail.com or Janet McKenna at email@example.com. 7 to -9 p.m. Acoustic Neuroma Panel discussion. Acoustic neuroma is a benign tumor growing on the auditory nerve. Ceci McCurdy started the local acoustic neuroma support group. She will head a panel of acoustic neuroma patients to discuss what it is, treatment options, and life as an acoustic neuroma patient. All HLAA programs are free. Anyone interested in hearing loss is welcome. For more information, view the organization’s website at hlaa-rochester-ny.org or telephone 585-266-7890.
Retirement workshop for couples in Pittsford Certified retirement coach Gary R Jay of Remarkable Reinvention and certified financial transitionist Kathleen Roth of Waterstone Financial Services are sponsoring a workshop for couples to discuss financial issues in retirement. The program, called “He Says / She Says,” is based on the notion that men and women have different views on retirement. The two professionals will help couple navigate through different retirement visions to find common goals and interest. The workshop will take place from 9 a.m. to 12 p.m., Saturday, Oct 21, at the Waterstone office at 10 Office Park Way in Pittsford. Description of this program can be found on WaterstoneFinancialServices.com/ he-says-she says. Cost is $45 per couple. For more information, call Gary Jay at 585-586-5641.
IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • September 2017
he following classes are sponsored by Lifespan, a nonprofit organization in Rochester that has provided service to area older adults and caregivers for 46 years. Courses are free of charge but online registration is required. To register, visit www.lifespanrochester.org or call the phone number indicated with the class listing.
Lifespan’s Living Healthy with Diabetes
Webster Senior Center, 1350 Chiyoda Drive • Wednesdays, 10 a.m. to 12:30 p.m., Sept. 6 through Oct. 11 • Free. Reservations required. 585498-4017 Lifespan’s A Matter of Balance (fall prevention) Greece Senior Center, 3 Vince Tofany Blvd. • Mondays, 12:30 - 2:30 pm, Sept. 11 through Oct. 30 • Free. Reservations required. 585498-4017 Lifespan’s A Matter of Balance (fall prevention) Webster Senior Center, 1350 Chiyoda Drive • Fridays, 10 a.m. to noon, Sept. 8 through Oct. 27 • Free. Reservations required. 585498-4017 Lifespan’s Aging Mastery This is National Council on Aging’s Aging Mastery Program. Ten classes are led by expert speakers who help participants gain the skills and tools they need to manage their health, remain economically secure, and contribute actively in the community. Lifespan, 1900 South Clinton Ave. • Tuesdays, 1 to 2:30 p.m., Sept. 12 though Nov. 14. • Free. Reservations required. 585287-6439 Lifespan’s Powerful Tools for Caregivers Provides caregivers with skills and confidence to better care for themselves while caring for others. Lifespan’s Lily Café at the Maplewood YMCA, 25 Driving Park Ave. • Wednesdays, noon – 2:30 p.m., Sept. 13 through Oct. 18 • Free. Reservations required. 585287-6360 A Matter of Balance (fall prevention) Lifespan, 1900 South Clinton Ave. • Tuesdays, 3 to 5 p.m., Sept. 12 through Oct. 31. • Free. Reservations required. 585498-4017 Lifespan’s Aging Mastery This is National Council on Aging’s Aging Mastery Program. Ten classes are led by expert speakers who help participants gain the skills and tools they need to manage their health, remain economically secure, and contribute actively in our community. Lifespan at the Westside Y, 920 Elmgrove Ave. • Mondays, 12:30 to 2 p.m., Sept. 18 though Nov. 27. • Free. Reservations required. 585287-6439 Lifespan’s Tai Chi for Arthritis Chili Senior Center, 3235 Chili Ave. • Tuesdays and Fridays, 9 – 10 am. Sept. 19 – Nov. 17. • Free. Reservations required. 585287-6439 Alzheimer’s: Know the Ten Signs Lifespan, 1900 S. Clinton Ave. • Wednesday, 2 to 3 p.m., Sept. 13, • Free. Reservations required. 585498-4017
Binge Drinking Rates Dropping on College Campuses But study also shows those rates are rising for young adults who are not in school
fter years of increases in binge drinking among the college crowd, new research shows those rates have now dropped. Unfortunately, the reverse held true for young adults who did not go to college. Between 1999 and 2005, binge drinking among college students jumped from 37 percent to 45 percent. But that trend reversed itself after 2005, landing back at 37 percent by 2014, according to the analysis from the U.S. National Institute on Alcohol Abuse and Alcoholism (NIAAA). Meanwhile, binge drinking rates among those who were not enrolled in college increased from 36 percent to 40 percent between 1999 and 2014. "For many years, there was an increase in the percentage of college
students in national surveys who binged," said study first author Ralph Hingson, director of the division of epidemiology and prevention research at NIAAA. "We saw that up until 2005. "But since then, the percentages have gone down," he noted. "Same thing for driving under the influence of alcohol and our estimates of alcohol-related unintentional injuries. "But there is still a lot of work to do," Hingson cautioned, with binge drinking on the rise among 18 to 24-year-olds who are not enrolled in college. "And this group now has a higher per-
centage of binge drinkers than sameage college students," he added. Binge drinking is defined as a pattern of excessive consumption that usually involves imbibing four drinks (among women) or five drinks (among men) within a two-hour period. To get a handle on binge drinking trends among young Americans, the investigators culled data collected by a wide swath of government agencies. The team found that alcohol-impaired driving among college students declined from 29 percent in 2005 to 17 percent in 2014. Similarly, alcohol-related unintentional injury deaths and traffic deaths fell nearly 30 percent and 43 percent, respec-
tively, among the same age group between 1998 and 2014. The findings were published in the July issue of the Journal of Studies on Alcohol and Drugs. Hingson suggested that the strides made against binge drinking on college campuses reflect "increased efforts at federal, state and community level to reduce underage drinking." For example, he noted that as of 2005 all 50 states had adopted an 0.08 percent blood alcohol level limit for drivers, up from just 17 states back in 2000. As well, 38 states now have underage drinking strategic plans. "The last thing is the downturn in the economy," he added. "People have less discretionary income, and so less money to spend on alcohol."
Healthcare in a Minute By George W. Chapman
It’s hard to report on the fate of this bill on a monthly basis because things are so fluid in Washington lately. But as of mid-August, the ACA, with all its pros and cons, is still the law of the land. The critical feature of the ACA right now are the two subsidies available to people with incomes between 100 percent and 400 percent of federal poverty guidelines. The first subsidy is a tax credit toward the premium of a bronze, silver or platinum plan. The second subsidy, CSR or “cost- sharing reduction,” is for out-of-pocket expenses like deductible and copays. The CSR subsidy applies only to silver plans. Of the 7 million people who buy on the exchanges, 58 percent receive the CSR. The CSRs will cost an estimated $7 billion this year. Congress filed a lawsuit against Obama, House v Price, claiming there is no authority for the expenditure of this money as all funds must be approved and appropriated by Congress. The court ruled in favor of Congress but the ruling was stayed by the Court of Appeals, so the whole thing is in limbo. If the CSR is ultimately revoked, it is estimated insurers would be forced to raise their rates on the exchanges by 19 percent. President Trump has threatened to end the CSRs which would virtually kill the exchanges.
You can get the price, or at least an idea of what something will cost, on just about anything in this world. Not so much in healthcare. Patient advocates believe price transparency makes sense as consumers are faced with rising out-of-pocket costs (deductibles and copays) and healthcare reformers believe price transparency
will create competition and lower costs. But it is not that simple. Shopping around for prices can be a fool’s errand because healthcare prices or charges have little to no relationship to either the cost of the procedure or what your insurance eventually pays the provider. Hospitals are reluctant to quote a price because they don’t really tell the consumer anything. One hospital may quote you a price/charge of $20,000 and another hospital $15,000. But the odds are both will be reimbursed virtually the same by your insurance company. The explanation of benefits (EOB) you receive after a hospitalization from your insurer tells the story. The charges total $20,000, but your insurer paid only $5,000. Your deductible and copays are based then on the $5,000 reimbursement , not the $20,000 price/charge. Also consider that the vast majority of consumers will be hospitalized where their physician works or refers them. While hospital charges are meaningless and indefensible, it makes little sense for consumers to shop around for care based on “prices.” Hospitals are reluctant to lower their prices/charges out of fear consumers will think the care isn’t as good as a hospital with higher charges.
Single Payer System
California, New York, Colorado and Vermont have all introduced legislation for a single payer or “Medicare for all” plan. Concerns over costs have killed the bills. Ironically, the per capita cost of care in every country with a single payer system is much lower than in the U.S and quality is not compromised. An argument for a single payer system by Cornell professor Robert Frank appeared in New York Times in July. He argues that costs are lower under single payer systems. Administrative costs September 2017 •
for single payer systems, (Medicare is around 2 percent), are far less than for private payers which are around 10-15 percent. Single payer systems don’t need to advertise which accounts for a lot of the administrative costs. As a matter of fact, in order to attract private insurers into the Medicare Advantage market, the federal government had to subsidize their high administrative costs. Single payer systems have far greater negotiating power with providers and suppliers. Medicare has already set physician and hospital payments so further efforts to save money there would be getting blood from a stone. The biggest savings would be from drug and device manufacturers which heretofore have been left unscathed thanks to intense lobbying. Single payer systems cover everyone, under one huge risk pool, young and old, healthy and unhealthy. No exceptions. Our several government risk pools — for example: Medicare, Medicaid, VA — cover disproportionate amounts of people who need medical attention. Our population is further divided into literally tens of thousands of smaller risk pools as most businesses with over 200 employees are self-insured. In a single payer system, all must participate and, yes, all will pay taxes. But our entire system would collapse if tax payments were purely voluntary.
These highly effective and addictive pain killers include OxyContin, Percocet, Vicodin and fentanyl. 62,000 people died last year of an opioid overdose. Nearly half of the opioid deaths involved prescriptions. The epidemic is worsening every year. In 2010, 16,000 people overdosed. The national average is 10 overdoses per 100,000. It’s 30 per 100,000 in New Hampshire and 40 per 100,000 in West Virginia. Opioids are the most prescribed drug in the US with about 289 million scripts a year. As the epidemic grew, heroin became more prevalent as it was cheaper, easier to get and didn’t require a script. In the 1980s, many medical experts thought opioids were not addictive due in part to a letter published in a popular medical journal in 1980. “Addiction Rare in Patients Treated with Narcotics” may have unwittingly been the genesis of the epidemic. It is estimated that over 1 million people have been eliminated from the job market because of their addictions. Big pharma has done well. Purdue pharma has made over $3 billion on their OxyContin. They have paid over $635 million in fines for misleading physicians and the public. Substance abuse treatment costs us about $600 billion a year.
Physician Jerome Adams has been confirmed as our 20th surgeon general. Adams was an assistant professor of anesthesiology at Indiana University School of Medicine before becoming Indiana’s commissioner of health. One of his first priorities will be tackling the opioid epidemic. The position of surgeon general began in 1871 to head the Marine hospital service.
George W. Chapman is a healthcare business consultant who works exclusively with physicians, hospitals and healthcare organizations. He operates GW Chapman Consulting based in Syracuse. Email him at firstname.lastname@example.org.
US Surgeon General
IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper
By Chris Motola
Certain Jobs Linked to Raised Risk of Rheumatoid Arthritis Manufacturing jobs, those who work as bricklayers or with concrete at higher risk of developing condition
isk was doubled among men who did electrical work, and tripled among bricklayers, study finds Rheumatoid arthritis, a painful disease in which a person’s immune system attacks the joints, appears to be more common among people in certain types of jobs, researchers suggest. The findings “indicate that work-related factors, such as airborne harmful exposures, may contribute to disease development,” study author Anna Ilar said. She is a doctoral student in epidemiology at the Karolinska Institute in Stockholm. The study looked at more than 3,500 people in Sweden with rheumatoid arthritis, and nearly 5,600 people without the disease. Among men, those in manufacturing jobs had a higher risk of rheumatoid arthritis than those in the professional, administrative and technical sectors, the findings showed. The risk was twice as high for electrical and electronics workers, and three times higher for bricklayers and concrete workers. Among women, assistant nurses and attendants had a slightly higher risk, but women in manufacturing jobs did not. The researchers suspect that’s because fewer women than men work in manufacturing. More study is needed to zero in on the exposures that may be involved, Ilar noted. Potential culprits include silica, asbestos, organic solvents and engine exhaust. The report was published online Aug. 10 in the journal Arthritis Care & Research. “It is important that findings on preventable risk factors are spread to employees, employers, and decision-makers in order to prevent disease by reducing or eliminating known risk factors,” Ilar said in a journal news release. The researchers said they accounted for lifestyle factors associated with rheumatoid arthritis, such as body fat, smoking, alcohol use and education level. However, while the study found an association between certain occupations and rheumatoid arthritis risk, it didn’t prove a cause-and-effect relationship.
Joseph A. Talarico, M.D. Hernia repair surgeon helps Thompson Health become a Hernia Center of Excellence, the first of its type in New York state Q: Give us an overview of the type of surgery you perform. A: I operate on inguinal, groin, abdominal, ventral or diaphragmatic hernias. I primarily use a robot, a minimally invasive procedure, and patients are usually back to work within about three days. They take only over-the-counter pain control and ice for the wounds.
Q: Is there such a thing as a hernia that can be safely ignored A: Generally, patients come to me. It’s an elective situation, so they’re symptomatic. We offer an operation whenever their hernia is identified. There was a time when “watchful waiting” was considered a reasonable medical response, but now we know that hernias don’t resolve on their own. So, we offer, on an elective basis, the robotic procedure which can be done with three small incisions, followed by over-thecounter pain treatment. For emergent situations, where the bowel may be stuck in the hernia and become necrotic or twisted, those situations are treated with either a laparoscopic or open approach. Q: Why the different approach? A: In an emergent situation, surgeons are more likely to use an open approach. I prefer to use a laparoscopic approach myself for my emergent procedures, since we can use smaller incisions. Unfortunately, on an emergent basis, the patient may not have the opportunity. There may be a bowel obstruction and we might have to remove a portion of the intestine. By offering the elective procedures, we’re trying to avoid having to do the emergent ones. Q: Who is most at risk for hernias? A: The risk factors for hernia are chronic
cough, constipation, obesity and smoking. Men are more at risk than women, and your right side is more at risk than your left. Patients who suffer sports-related hernias tend to be young men and women who play sports like soccer, lacrosse and football.
Q: So, it’s easy to understand why something like a sports injury could cause a hernia, but how does obesity or smoking increase your risk? A: Smoking affects the small vessels in the body. As you know, every day your body is repairing itself. That’s what happens during sleep — your mind gets the opportunity to fix your body while your body is resting. Smoking prevents delivery of oxygen by constricting the small vessels. Part of the high you get from nicotine is the constriction of the small vessels. So, you’re unable to repair the tears you’ve suffered throughout the day. Obesity is a bit more simple. An obese patient may be carrying around 100 extra pounds of weight. That’s an extra 100 pounds of pressure on a daily basis. That’s a big deal. There’s only so much the body can take. Think of it this way: someone carrying around 100 extra pounds of weight is shouldering two 50-pound bags of cement every morning. The extra pressure and tissue around their abdomen is simple physics. Q: How did Thompson Health become a Center of Excellence for hernia repair? A: I’m the director of the center of excellence here at Thompson Hospital. We’re the only hernia center of excellence in New York state and the only one nationally without residents or fellows. It’s primarily myself, my three colleagues and support staff with help from administration. The qualifications are fairly rigorous. They do a very detailed investigation of your processes, your approach and your outcomes. They come to the campus for several
IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • September 2017
days and watch the process from the beginning to the end. My colleagues and I are all equally trained and know each other’s processes very well. My patients tend to have recurrent and sports-related hernias. They’re patients who tend to want to get back to work fast. That’s in contrast to my other colleagues who tend to perform complicated abdominal repairs. We also deal with hernia-related complications, like chronic mesh infections. Q: Can you describe the mesh you use to repair hernias? A: The hernia repair that we offer uses primarily mesh repairs, though in some circumstances we’ll use a bio-absorbable mesh from a porcine or human source. We usually use a wide-pored polypropylene mesh. It can be rescued in infections and usually doesn’t have to be stitched into place, so there’s no tension when it’s put into place. It’s similar to human tissue in strength. To the eye, it looks a bit like a fishnet stocking with wide spaces. Part of the reason patients can get back to work so quickly is that it’s so thin and wispy. You obviously won’t want to immediately try for your personal best at the gym or play football, but you can usually be back to work in three days and back to full activity in about a month. Q: Since this is an elective surgery, at what point should a patient move from “maybe I should get this done” to “I’d better get this done?” A: So, the spectrum goes from elective, to urgent, to emergent. The elective cases can feel it or see it. The urgent cases tend to be a patient coming to the emergency room after being unable to reduce their hernia. They’re experiencing pain and tenderness. They’ll get scheduled ahead of the elective cases. The emergent cases are when something gets stuck in the hernia or there are skin changes. They’ll be in the operating room within hours of being identified. Q: How broad a region do you serve, given the center of excellence designation? A: I’ve had consults from as far away as Canada. That’s a high honor, because Canada is very concerned with cost effectiveness. We’re exceptionally cost effective. But I see people from Buffalo, Syracuse, Albany.
Name: Joseph A. Talarico, M.D., F.A.C.S. Position: Director of Surgical Center of Excellence at F.F. Thompson Hospital Hometown: Cleveland, Ohio Education: University of Toledo; University of Illinois; Case Western Reserve University Fellowship: Advanced laparoscopic and bariatric surgery; Cleveland Clinic Foundation. Residency in general surgery, University of Illinois, Metropolitan Group Hospitals, Chicago. Affiliations: Thompson Health; Geneva General; Clifton Springs; Newark-Wayne Organizations: American College of Surgeons; Association of Metabolic Surgeons; Society for Surgery of Alimentary Tract Family: Married, two children Hobbies: Weight-lifting; road trips
Fun Ways to Get Fit This Fall Walk your way to wellness: Opportunities abound
Take on longer life with Lifespan!
Night Lights at Griffis Sculpture Park, 6902 Mill Valley Road, East Otto. This 400-acre park near Ellicottville is home to over 250 sculptures — many of which you can climb up, in and on. It is one of the largest outdoor sculpture parks in the U.S. By Kyra Mancine
s we bid farewell to summer, thoughts turn to cooler, crisp days, sweater weather and the sound of leaves crunching beneath our feet. There is still plenty of time to enjoy all that nature has to offer — without worrying about bugs and sweltering temperatures. Make the most of the season by venturing outside to explore. Here are some events that allow you to admire the leaves as they change color and get your heart rate up at the same time!
Genesee Valley Nature Conservancy Walks
– Big Tree Walk: 2 p.m., Sunday, Sept. 17, Big Tree Lane, Geneseo. Learn about the “Big Tree” and the efforts to preserve the last section of it. This free event is part of the 2017 Nature Series (held in partnership with the Livingston County Historical Museum). Since the tree is on private property, this is a rare opportunity to see and learn about a Geneseo landmark. – Creek Walk: 9 a.m., Saturday, Sept. 30, at 2053 Bush Road, Leicester. Join a geologist from SUNY Geneseo for this free, one mile walk where you will learn about Little Beards Creek, a protected property. The walk will take between an hour and an hour and a half. The trail is flat and relatively dry with a few hilly parts. For more information on both events, visit www.geneseevalleyconservancy. org/events
Amazing Maize Maze: 20 Years of Twists & Turns
Long Acre Farms, 1342 Eddy Road, Macedon Feeling a little corny? Test your navigation skills, day or night! There’s also an Animal Tracks Maze for younger children (daytime only). Experience Moonlight Mazes ($12 for ages 5 years and up) on Fridays
and Saturdays, starting Sept. 23 (6 to 11 p.m.) thru Oct. 28. Visit https:// longacrefarms.com/ for more information.
Night Lights, Griffis Sculpture Park, 6902 Mill Valley Road, East Otto.
This 400-acre park near Ellicottville is home to over 250 sculptures — many of which you can climb up, in and on. It is one of the largest outdoor sculpture parks in the U.S. During Night Lights, you can take an unguided walk to music “where the trails and sculptures interact with creative lighting.” Go before the sun sets and walk the trails as well. The views are spectacular. It’s hilly, so good walking shoes are a must. Don’t forget your flashlight! Visit http:// griffispark.org/ for dates (in Sept TBD) and admission fee details.
Adventure & Scaerial Adventures Bristol Mountain, 5662 Route 64, Canandaigua
If you’re not afraid of heights, the Aerial Adventure Park is a good choice. It offers seven courses with over a dozen zip lines, tight rope walks, rope ladders and bridges between platforms secured to trees. There’s also a Kids Adventure Park with two courses for kids aged 4 to 7. As we creep closer to Halloween, they also offer “Fun & Frights” which consists of haunted zip lines and eerie bridges. You can chose from “Spooky” (not scary, for ages 7 and up) to “Sc-aerial“ described as “not for the faint of heart.” Bristol is open weekends, 10 a.m. to 4 p.m., and Columbus Day. Admission fees are required for all courses. Visit www. bristolmountainadventures.com/ for more information. Want to stay closer to the ground? Check out these walking tours: September 2017 •
Genesee Valley Hiking Club History Walk
Saturday, 10 a.m., Sept. 30, at 7271 W. Main St., Lima. This two-hour walk (for all ages and fitness levels) does include some hills and an optional lunch after at the historic Lima Hotel. There is an $8 yearly membership fee (per household) to join the hiking club (checks only). For more information, visit www.gvhchikes.org/sched.html
General and Theme Walks, Mount Hope Cemetery, Rochester
The Friends of Mount Hope Cemetery offer general ($5) and guided theme ($7) tours Sundays at 2 p.m. through Oct. 29, as well as on Labor Day (cash/check only). Free to members or kids under the age of 16 when accompanied by an adult. The cemetery does have varied terrain, so be sure to wear appropriate shoes (no sandals please). No pets allowed. For tour descriptions, visit www. fomh.org/Events/SpecialTours/
Themed Walking tours:
– Home to the Prosperous and Penniless, 11 a.m., Saturday, Sept. 23, South Entrance. – Geology of Mt. Hope Cemetery, 11 a.m., Saturday, Sept. 30, North Gatehouse – Mischief, Murder & Mayhem, 11 a.m., Sunday, Oct. 7, North Gatehouse – Rochester’s Gilded Age, 11 a.m., Saturday, Oct. 14, North Gatehouse – Fall Foliage, 11 a.m., Saturday, Oct. 21, North Gatehouse – Rochester’s Political Players, 11 a.m., Saturday, Oct. 21, South Entrance
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Plant-Based Diet Don’t miss the next issue of In Good Health
IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper
Live Alone & Thrive
By Gwenn Voelckers
Practical tips, advice and hope for those who live alone
Living Alone Takes Courage
was inspired to write this column on courage after receiving the email below from a reader last month: Dear Gwenn, You would appreciate this. I just have to share these two recent experiences I had as a single woman. Last week, I went to a concert on the spur of the moment called “Old Hippies Reunion.” As a Baby Boomer (and former hippie), I thought it might be interesting and fun. I dined out alone at a restaurant, then left alone to enjoy the concert in a nearby music venue. I tried my best to adopt the posture of a confident single woman at a bar — you know, that casual look. I faked it for a while, then retreated to the safety of my car, and ultimately to my couch at home. Still, I felt good that I made the effort! Then this week, I went to meet a “match.com date” — only I went to the right place on the wrong day. I waited
an hour, established rapport with the single-mom hostess and then gave up. I went into the dining room, ordered a glass of wine and an appetizer. Clearly the waitress thought it most odd I was alone. (I did not have the courage to eat outdoors where all of the other couples had seen me waiting for an hour). Last night, I met the gentlemen at the right place on the right day. It was a pleasant first, but last encounter. Being single requires courage! Kathy (not her real name) How right this reader is. Living alone does require courage. In fact, Kathy’s email got me thinking about all the many and varied ways that living alone asks (demands!) that we demonstrate courage, almost on a daily basis. On my own, I’ve discovered it takes courage to:
LOWER UNINSURED RATE THAN THE NEW YORK STATE AVERAGE
Sleep alone. That “bump in the night” can test even the strongest among us. Get up alone. Where did all this anxiety come from? I just want to stay in bed! Show up alone. Walking in alone can still feel so uncomfortable. Especially if my ex is at the event. Throw a party. What was I thinking? Will anyone show up? The bathrooms still need cleaning! Ask for help. When am I going to stop letting my pride get in the way? Set a mousetrap. Or worse, dispose of one that’s “occupied.” Say “no” to an unwelcome advance. Despite how lonely I feel, the
ring on his finger is a showstopper.
Say “yes” to a welcome invitation. He’s kind and kinda cute. But
then what? At my age? Travel alone. You mean I have to carry my own luggage? Make my own flight arrangements? Enjoy blissful time alone, with my own good company? Yes! I guess this one doesn’t take much courage. Tackle a home repair. Hey, if a guy can replace the flapper in the toilet tank, I can, too. Make a major purchase. I know I should be practical, but what I really want is that sporty red convertible.
What to do?
Be nice to my ex. After all, we did share some good times together.
Once and for all, start exercising. I know it’s good for me. And
could add quality and years to my life. What’s stopping me?
Survive a Saturday night alone.
Why is this so daunting? I need to get a grip. Or, a good book.
Express true feelings. If not now, when?
On that last item, writing this column takes courage. Within these columns, I share some of my deepest feelings, thoughts and fears. I make myself vulnerable. And that takes courage. But, guess what? When we demonstrate courage and take risks, we grow. We become stronger, more resilient, more independent, and more able to live the life of our dreams. We become better at living alone. And that’s a good and courageous thing to do!
Gwenn Voelckers is the founder and facilitator of “Live Alone and Thrive,” empowerment workshops for women held throughout the year in Mendon. For information or to contact Voelckers, call 585-6247887 or email: gvoelckers@rochester. rr.com.
LOWER THAN THE NATIONAL UNINSURED AVERAGE
Across upstate New York, the uninsured rate in 2015 was just 4.6 percent. This compares with a New York state average of 7.1 percent and a national average of 9.4 percent. In 2015, upstate New York’s under-65 health insurance coverage rate was 94.6 percent, already exceeding the federal goal of 90 percent by the year 2025. We’re proud to offer lower-cost private coverage than the national average that helps more people afford coverage. We’re neighbors helping neighbors build healthier communities.
A nonprofit independent licensee of the Blue Cross Blue Shield Association.
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IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • September 2017
Men’sHealth Men and Their Belly Fat Call it beer belly, love handles, spare tire: doctors say men with large bellies have increased risk of death by various associated diseases By Deborah Jeanne Sergeant
ove handles, spare tire, beer belly: whatever it’s called, it’s not pretty and it can actually harm a man’s health. The issue is that weight around the belly is visceral fat that surrounds the organs. Joy Valvano, registered dietitian and certified diabetes educator with Rochester Regional Health, said that this deep fat increases risk of some chronic disease like cardiovascular disease, insulin resistance, Type 2 diabetes, and high blood pressure, colorectal cancer, sleep apnea. UR Medicine Primary Care physician Louis Papa said that the location of these fat deposits — not the overall weight — is what’s so vital. “People with a normal body mass index (BMI) but with more belly fat are at a greater risk of disease than people with a high BMI but normal amount of belly fat,” Papa said. He added that people with an abnormal amount of belly fat have a 51 percent increased risk of death by various associated diseases than those with a normal amount of belly fat. “Since belly fat is related to insulin resistance and inflammatory changes, that puts you at higher risk for these diseases,” Papa said. “These fat cells have a lot of hormonal activity. The belly/hip fat produces a lot of endocrine and hormonal activity that puts you at risk for diabetes and heart disease.” So how can you specifically get rid of belly fat? “We don’t know a good way to get rid of just belly fat,” Papa said. Although lots of marketing hype promises to blast belly fat with a product or technique, it’s not that easy since weight loss can’t target one area. Instead, try these expert tips: • Don’t use fad diets. “With a lot of fad diets, 95 percent of people gain the weight back. Any diet that has some sustained weight loss is pretty modest: 10 to 15 pounds of weight loss on average,” Papa said. • Reduce caloric intake. “People who lose weight measure, measure and measure more. They count calories and they’re very driven to that. Some count it with points or portion sizes and they stick to it,” Papa added. • Tone muscles. “We know that eating well and increasing activity both go a long ways towards helping us lose weight. Abdominal muscles can be toned through exercises. The way to get rid of belly fat is to lose weight overall,” Valvano said. • Eat better foods. “Emphasize more plant-based foods: lean protein, whole fruits and vegetables, and limit sources of animal-based fat. Choose more mono-saturated fat and poly-unsaturated fat in nuts,
fish, and vegetable oils. Don’t overdo them, but they are better choices,” Valvano said. • Choose better beverages. “Avoid sugary drinks and alcohol. It contributes to excess weight,” Valvano said. • Get help and get moving. “Talk with your doctor if you haven’t been exercising. The physical activity recommendation for most healthy adults is moderate aerobic activity for 150 minutes a week, plus strength training a few times a week. You may need to exercise more for specific weight loss goals,” Valvano said. • Be patient. “We recommend when people want to lose weight they should aim for slow, steady weight loss. You don’t want to go on a crash diet or excessively exercise. It can be hard to maintain that level of restrictive diet,” Valvano said.
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“People with an abnormal amount of belly fat have a 51 percent increased risk of death by various associated diseases than those with a normal amount of belly fat.” UR Medicine Primary Care physician Louis Papa
Belly Fat: Do You Have One? Not sure if your girth is too great? The way clothing fits can be deceiving, as low-rise and high-rise styles don’t indicate where your waist really is. Try this tip from Joy Valvano. Stand up, place a flexible tape measure just above the hip bone and around you snugly and level all the way. Don’t suck in your belly. If the measurement is greater than 40 inches, you have too much belly fat. September 2017 •
Despite my being camera shy, Dad loved taking my picture.
Dad patiently taught me how to drive a stick shift.
Dad walked me down the aisle.
So happy to be there for Dad as he moved to his own new apartment!
With maintenance free living in one of our spacious apartments, you'll find you have even more time to enjoy life's special moments.
IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper
Only About OneThird of Americans Use Condoms: CDC They aren’t the best method of birth control, but they do help prevent STDs, health experts say.
Condoms can help prevent pregnancy and the spread of sexually transmitted diseases (STDs), but only about a third of Americans use them, a new federal report shows. “The use of condoms is a public health issue,” said report author Casey Copen, a statistician at the U.S. Centers for Disease Control and Prevention’s National Center for Health Statistics. “STDs can lead to long-term consequences, such as infertility,” she said. “Condoms, when used consistently and correctly, reduce the risk of HIV and STDs.” About 20 million new cases of STDs are diagnosed each year in the United States, the CDC said. These infections include human papillomavirus (HPV), gonorrhea, chlamydia, syphilis, hepatitis and HIV. The choice of whether to use a condom or not is influenced by a number of factors. These include: a woman’s desire to get pregnant, one’s experience using other methods of contraception, and the relationship of the partners, Copen said. “People who say they are dating casually use more condoms than people who say they are co-habitating or engaged,” she said. Most people who use condoms say they use them to prevent pregnancy and avoid getting an STD, Copen said. One expert said there are other, better choices of birth control. “We have much better methods of birth control than a condom. If people don’t want to have a baby, they should be using a more effective method,” said physician Jill Rabin. “Sex can be wonderful, but I don’t know any climax that’s worth the heartache of an unwanted pregnancy,” said Rabin. She is cochief of the division of ambulatory care in the Women’s Health Programs-PCAP Services at Northwell Health in New Hyde Park, in the New York City region. But condoms do have a role in preventing STDs, Rabin said. Often people don’t know they have an STD until it’s too late and they are infertile or sick, she said. “We know that condoms can protect against many STDs,” Rabin said. “So why would you deliberately place yourself in a position to get hepatitis B or C or HIV? “I understand human nature, but take responsibility and think ahead,” Rabin said. Page 10
$100 Sweetens the Pot for a Colonoscopy Study found those who were offered cash to get cancer screening were twice as likely to do so
t appears that $100 might go a long way toward convincing someone to get a colonoscopy. New research found that such a cash incentive doubled the chances that older adults were screened for colon cancer. “Colonoscopy is challenging for patients, requiring a day off from work, a bowel-cleansing preparation, and transportation, in addition to non-financial costs of anxiety and discomfort,” said study author, physician Shivan Mehta, an assistant professor of medicine at the University of Pennsylvania in Philadelphia. “The improvement we saw in the rate of screening colonoscopies was statistically significant, and shows for the first time that a financial incentive can at least modestly boost that rate,” Mehta added in a university news release.
Colon cancer kills more than 50,000 people in the United States every year, second only to lung cancer. But most potential tumors can be detected by colonoscopy and removed, usually before they become cancerous, researchers said. The study included more than 2,000 people between the ages of 50 and 64. All were eligible for colonoscopy screening. Some received an email asking them to opt in or opt out of a screening colonoscopy (the simple active choice group). Others received an email with the same message plus an offer of $100 if they had a colonoscopy within three months. A third group (the control group) received an email with just a phone number for scheduling a colonoscopy. After three months, almost 4 percent of those in the $100 offer group
had undergone a colonoscopy, compared with 1.6 percent in the control group and 1.5 percent in the simple active choice group. The rate of colonoscopy appointment scheduling was 5 percent in the $100 offer group, 2.1 percent in the control group and 2 percent in the active choice group. The effectiveness of the financial reward may be due to the large amount of money and the fact that it was offered along with easy access for booking an appointment, Mehta suggested. “Although a $100 incentive seems relatively large, this amount is comparable to what employers already offer for completion of health risk assessments or biometric screening activities,” he said. The study was published recently in the journal Gastroenterology.
Most American Men Qualify as ‘Overfat’ Most women and a lot of kids also appear to have excessive fat, study of developed nations reports
ost American men are “overfat,” and most American women are not far behind, a new study says. Overfat refers to having excess body fat that can pose a threat to health. And the study authors from Australia and New Zealand said it’s a separate term from measures of body mass — in other words, even normal-weight people can be overfat. The authors ask: Does your waist measure more than half your height? If so, you may be overfat. Excess body fat, especially abdominal fat, increases the risk of chronic diseases such as diabetes and heart disease, as well as death, the researchers said. In the United States and 29 other developed countries, up to 90 percent of men, 80 percent of women and 50 percent of children are overfat, according to the study in the journal Frontiers in Public Health. “The problem is particularly pervasive in the English-speaking countries of the United States and New Zealand, but also in Iceland and even Greece where people are gener-
ally thought to be healthy,” said the researchers led by Philip Maffetone, from MAFF Fitness in Sydney. Even many physically active people in the United States, including professional athletes and U.S. military personnel, may be overfat, the researchers said in a journal news release. In a previous study, the same team of researchers found that up to 76 percent of the world’s population may be overfat. The researchers said excess body fat leads to insulin resistance, chronic inflammation, high cholesterol and high blood pressure. Traditional methods of measuring weight or body mass index (BMI — an estimate of body fat based on height and weight) are ineffective in assessing whether a person is overfat, the study authors said. They recommend measuring the waistline (at the level of the belly button). If the waist measure is more than half the height, a person is overfat.
IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • September 2017
Vasectomy Procedure remains popular as men use it as a contraceptive method By Deborah Jeanne Sergeant
ith all the varieties of contraceptives available, are vasectomies still popular? Area experts say yes — and for good reasons. Ali Houjaij, chief of urology and a urologist at the Buffalo VA, said that more men are asking for vasectomy. “It’s easier and safer than tubal ligation,” he said, referring to the equivalent female sterilization method. “Some guys ask, ‘which is easier and safer?’” Vasectomy costs about one-third that of female sterilization via tubal ligation. Houjaij explained that although vasectomy is a surgical procedure, it’s performed under local anesthesia as an out-patient surgery. Only 5 to 10 percent of men experience chronic scrotum pain, and only a small percentage of those find it to be life-changing. The chances of injury to the blood supply can cause loss of testicle, but less than 1 percent of men experience this side effect. Less than
5 percent of men experience bruising and infection. Ryan Sidebottom, urologist with Upstate Urology of Auburn, said that the new “no-scalpel” technique provides “a minimally invasive way of doing it, as it is uses one poke in the center of the scrotum. We can bring out the vas deferens and separate the connection. “Some guys wonder why they were so worried, once it was done. It’s a very tolerable procedure,” Sidebottom said. Despite local popularity of vasectomy, the U.S. overall lags behind Canada and the UK, according to United Nations figures. American women experience double the tubal ligations as men experience vasectomy; however, the large number of cesarean sections performed in the US may account for some of that figure, since for couples done having babies, it’s easier to go ahead with sterilization for the partner who’s already undergoing surgery.
6 Vasectomy Misconceptions Men commonly believe in a few misconceptions about vasectomy.
It’s easily reversible.
“Reversal is not easy. It requires a three-hour procedure under general anesthetic. The success rate after a vasectomy reversal can range from 50 percent with a common urologist to 70 percent with a reversal specialist. Vasectomy should be done only for the man who’s absolutely sure he doesn’t want any more kids.”
Vasectomy reduces erections and sexual satisfaction.
“Vasectomy does not affect sexual function, including the amount of ejaculate. The testicles contribute very little ejaculate. Most is from the prostate.” Ali Houjaij, chief of urology and a urologist at the Buffalo VA
3 4 5
Few other men seek vasectomy.
“It’s actually quite popular. There are very few birth control methods for men.”
Tubal litigation of women is better.
“[Vasectomy] is cheaper and safer and less risk of failure compared with tubal ligation for women. It’s easily covered by nearly all insurance.”
Recovery is difficult and sex is off-limits for a long time.
“After the surgery and three days’ rest, they can have sex but with protection. Eighty percent of guys clear at two months. Other may require a few more ejaculations to get sperm count to zero. I use very specialized instruments that allow for a very delicate dissection of the vas tubes. There’s very little downtime. I do a lot on Thursday or Friday so by Monday, they’re back to work.”
It likely won’t work.
“The chance of failure is less than 1 percent, compared with 3 percent for tubal ligation.” J.C. Trussell, associate professor and urologist with Upstate University Hospital’s Urology Department. No urologists in the Rochester area responded for multiple requests to comment for this article.
Do Muscle Supplements Work? Health food stores feature shakes and body building supplements that promise to pack on pounds of muscle — but do they work? We speak with two experts By Deborah Jeanne Sergeant
ealth foods and fitness stores stock many kinds of shakes and body building supplements that promise to pack on pounds of muscle. But can these really help you get the body of your dreams? First, consider the source of the product’s claims. Supplements aren’t regulated by the Food & Drug Administration like medication. Manufacturers’ claims are not approved by the FDA and do not have to present double-blind, peer reviewed studies before they make claims. They must be safe and contain the ingredients they claim — that is all. “There are some muscle mass supplements that are beneficial, but they’re not without disadvantages,” said Joy Valvano, registered dietitian and certified diabetes educator with Rochester Regional Health. She said that some people taking creatine do experience increased muscle strength, along with proper resistance training. “Argon is thought to promote blood flow to the muscle, which may result in improved performance.”
Some people experience gastro-intestinal problems when taking creatine. Valvano said that it is also thought to cause long-term renal or kidney damage. “You can use real food that contains protein,” Valvano said. “Branch chain amino acids can be used to build muscle and are thought to increase fat burning.” She encourages men who want to build muscle to look at plant-based protein, which is low in saturated fat, such as nuts, hemp seed powder, sprouted bread, and quinoa. These sources combat inflammation, provide fiber and B vitamins and are heart-healthy. “It’s a myth that animal protein is the only one to grow muscle,” Valvano said. For people who include dairy in their diet, she said that low-fat dairy could also offer a source of protein. Chris Sutton, certified personal training and strength and conditioning coach, owns Wergo, Inc., a personal training business in Rochester. He said that he’s not a big believer in muscle building supplements. September 2017 •
“You can get most of it through nutrition,” he said. “If you eat healthy, then it’s good enough.” Just as plain water usually suffices for adequate hydration over sports drinks, eating protein rich foods usually provides enough protein for those building muscle. Sutton recommended dairy, legumes, seeds and meat as good protein sources. “If you’re not getting enough protein, protein supplements can help, but you can get most of it through your regular diet,” he said. Spending more money on special supplements won’t result in more muscle. Eating right “is more important than supplementation,” Sutton said. “Your body uses that naturally sourced protein better, I think.” Simply consuming more protein from any source is not enough to build muscle. Engaging in regular resistance exercises “is more important,” Sutton said. He maintains that “form is everything.” “Some sacrifice weight for form or go too fast,” he added. “They
Joy Valvano, registered dietitian and certified diabetes educator. move the weight instead of contracting the muscles and engaging the abdominals. They may do too much, particularly if they are new.” He likes kettle bells, tubing and free weights for resistance training over weight machines. Instead of just stressing one movement, such as raising the weight, men should lower the weight with just as much care to work both muscles. Use the maximum amount of weight that can be lifted in good for about 10 repetitions. Perform another 10 repetitions and then move on to another muscle group. Exercise each muscle group twice weekly, but not two days in a row.
IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper
The skinny on healthy eating
4 Reasons to Eat Sesame Seeds
lthough beloved on bagels, breadsticks and hamburger buns, many folks can’t say why sesame seeds are good for health. Too tiny to make a difference? Too much of a “topping” to warrant investigation? Too common to think twice about? Whatever the reason (and I’ve been guilty of all three), it’s time to say “open sesame” to all that makes this small seed so big on nutritional benefits.
Bone-building minerals. It’s
remarkable how sesame seeds’ most abundant minerals — copper, manganese, magnesium and calcium — all contribute to bone health in some important way. With osteopenia bearing down on my rickety bones, I’m always on the lookout for calcium sources. Individually, copper helps make red blood cells and promotes healthy connective tissues; manganese is needed for digestion and nerve function; magnesium contributes to energy production; and calcium keeps our blood clotting and our hearts thumping.
Heart-healthy fiber. Men-
tion fiber and “regularity” often comes to mind first, which is indeed a good thing! But there’s so much more to this valuable nutrient. Current research shows that adding more fiber to your diet may lower blood pressure, improve blood cholesterol
levels and reduce the inflammation closely linked to all stages of atherosclerosis. Also, dietary fiber may help control diabetes. Just two tablespoons of sesame seeds provide about 4 grams of fiber (as much as one apple).
Cholesterol-lowering phytosterols. Sesame seeds
are loaded with phytosterols, those beneficial plant compounds that have been scientifically proven to lower cholesterol. Their benefits are so significant that foods are often fortified with phytosterols. Of course, having lower cholesterol levels leads to other benefits, such as a reduced risk of heart attacks and stroke. Antioxidant-rich phytosterols have also been found to help protect against the development of certain cancers.
Good-for-you fats. Sesame seeds are no slouch in the fat department, with just a few tablespoons serving up about 13 grams of fat. Thankfully, most are good fats — the mono and polyunsaturated fats. These fats help the body absorb nutrients and vitamins A, D, E and K that are vital to vision, strong bones and nerve development. They also help regulate hormones and body temperature and keep our skin, nails and hair in tiptop shape.
Cindy Fiege: A Life Lived in Harmony Owner of natural health store in Spencerport enjoys sharing knowledge of natural products, herbal medicine, supplements By Deborah Jeanne Sergeant
decade ago, Cindy Fiege, now 58, hadn’t planned to operate a natural health store. But she’s been doing just that since 2009 at Harmony Health Store, LLC in Spencerport. Her interest in natural health began when she became dissatisfied with the side effects of medication she took for a long-term knee injury. Despite the medicine, “I still wasn’t feeling great,” Fiege recalled. She hated taking medication after medication to treat all the side effects. Fiege visited a practitioner of natural health who recommended some Nature’s Sunshine brand supplements, which Fiege said worked well for her. She had previously used herbs to address her knee pain and inflammation, but at the time, she didn’t know about the importance of Page 12
taking quality products and using the herbs regularly as maintenance. She had worked as a hotel manager for 12 years and left that line of work. She thinks that the stress involved with the job represented another factor in derailing her health. She also wasn’t exercising or eating as healthfully as she should. While unemployed, she continued to learn about living a healthier, lower-stress lifestyle and supporting improved health by taking supplements which she said “turned my life around. I went from having no enthusiasm to being really excited about things. I got my pep back. I want to share it with the world.” When a retail space became available, she decided to open a store there so she could sell Nature’s Sun-
Sesame Bars with Walnuts, Coconut and Dried Cranberries Adapted from Bon Appetit
1¼ cups white sesame seeds ¾ cup unsweetened shredded coconut ¼ cup chopped walnuts (or nut of choice) ½ teaspoon kosher salt ¼ cup honey 2 tablespoons tahini (sesame paste) or creamy peanut butter ½ teaspoon vanilla extract ½ cup dried cranberries or raisins Preheat oven to 350°. Lightly oil an 8x8” baking pan; line with parchment paper or nonstick foil, leaving a generous overhang on all sides. Mix sesame seeds, coconut, nuts, and salt in a large bowl. Mix honey, tahini or peanut butter, and vanilla in a small bowl. Add to sesame seed mixture and mix well. Stir in cranberries. Scrape mixture into prepared baking pan; press firmly into an even layer. Bake until golden brown around the edges, about 20 minutes. Transfer to a wire rack and let cool until firm, 30–40 minutes. Lift out of baking pan (if it starts to crumble, let cool longer) and cut into bars or squares. Let cool completely. Store at room temperature or in fridge.
shine and other products that could help other people. “I am not telling to stop medication, but for me that was what I needed to do,” Fiege said. At this point, supplements, a healthful diet and gentle exercise help her keep her knee pain under control without the unpleasant side effects of prescription medication. “I still have a serious issue and should have a knee replacement,” she said. “I can’t run a marathon, but for everyday tasks, I can do OK.” Her husband of 36 years, Randy, is a trained reiki practitioner and shares the Harmony Health space to meet with clients. In 2008, Fiege also become trained in reiki and certified as an herbalist. When meeting with new clients, Fiege focuses on adrenal support, since she thinks that many health issues such as fatigue can start in that part of the body. Dovetailing her interest in natural health, Fiege enjoys healthful cooking and began a Facebook page “Cin-fully Delicious Real Foods” to share her culinary discoveries. “I emphasize on healthy dishes on the page,” Fiege said. “Truth is that I could whip up a delicious meal in no time.” In addition to natural health, Fiege enjoys working puzzles, gardening, walking and spending time with her family.
IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • September 2017
Helpful tips: If buying sesame seeds from bulk bins, take a whiff and a gander: they should smell fresh and be free of any moisture. Store hulled seeds, which are more prone to rancidity, in the fridge or freezer; unhulled seeds can be stored in an airtight container in a cool, dark place. Boost your consumption of this nutritious seed by adding it to baked goods, meatloaf and stews, and by sprinkling it on vegetables, meats, noodles and more.
Anne Palumbo is a lifestyle colum-
nist, food guru, and seasoned cook, who has perfected the art of preparing nutritious, calorie-conscious dishes. She is hungry for your questions and comments about SmartBites, so be in touch with Anne at email@example.com.
Cindy Fiege, now 58, operates Harmony Health Store, LLC in Spencerport.
Not All Fidos Are Friendly
800,000 Americans receive medical care for dog bites annually
ids love dogs — dressing them up, tugging on them, kissing them, and even riding them like a horse. But sometimes, things can end badly, a pediatricians’ group says. That’s probably why children account for more than half of the 800,000 Americans who receive medical care for dog bites annually. Children are much more likely than adults to suffer serious injuries when bitten by a dog, and children are most likely to suffer bites from familiar dogs, according to the American Academy of Pediatrics. The group offered the following dog-bite prevention tips. • Never leave a small child and a
dog alone together. And that advice holds true even if it’s the family dog, a dog that you know, or a dog that you have been assured is well-behaved. Any dog can bite. • Don’t let your child play aggressive games with a dog, such as tug-of-war or wrestling. Teach children to ask a dog owner for permission before petting any dog. Let a dog sniff you or your child before petting, and stay away from the face or tail. • Pet the dog gently, and avoid eye contact, particularly at first. • Instruct children to move calmly and slowly around dogs, and to never bother a dog that is sleeping, eating or caring for puppies.
• Tell children that if a dog behaves in a threatening manner —such as growling and barking — to remain calm, avoid eye contact with the dog, and back away slowly until the dog loses interest and leaves. • Teach children that if they’re knocked over by a dog, they should curl up in a ball and protect their eyes and face with arms and fists. If your child is bitten by a dog, ask for proof of rabies vaccination from the owner, get the owner’s name and contact information, and ask for the name and telephone num-
ber of a veterinarian who is familiar with the dog’s vaccination records and history. Immediately wash out the wound with soap and water. Call your pediatrician because the bite could require antibiotics, a tetanus shot and possibly rabies shots. The doctor can also help you report the incident to the police, the pediatricians said. If your child has severe injuries, call 911 or take the child to an emergency room.
darkest days than non-dog owners were on long, sunny and warm summer days.” He is a professor at Norwich School of Medicine, at the University of East Anglia. “The size of the difference we observed between these groups was much larger than we typically find for interventions, such as group physical activity sessions that are often used to help people remain active,” Jones added in a university news release. The researchers noted that owning a dog is not a good idea for all older adults due to the demands of looking after a pet, but said their findings suggest new ideas to in-
crease physical activity. “Physical activity interventions typically try and support people to be active by focusing on the benefits to themselves, but dog walking is also driven by the needs of the animal. Being driven by something other than our own needs might be a really potent motivator and we need to find ways of tapping into it when designing exercise interventions in the future,” Jones said. The findings were published July 24 in the Journal of Epidemiology and Community Health.
Walking the Dog, All the Way to Better Health Even in bad weather, seniors get about 30 minutes of daily activity by taking care of their pet
our dog may be more than your furry companion — new research suggests it may also be an effective personal trainer. The study found that dog walking gives a significant boost to older adults’ exercise levels year-round. Researchers looked at more than 3,000 older adults in England. Dog owners who walked their pooch got an average of 30 minutes more physical activity a day than other participants. The dog walking-linked boost in activity was especially noticeable in the winter when days are shorter, colder and wetter, the study authors said.
“We found that dog walkers were much more physically active and spent less time sitting overall. We expected this, but when we looked at how the amount of physical activity participants undertook each day varied by weather conditions, we were really surprised at the size of the differences between those who walked dogs and the rest of the study participants,” said study lead author Yu-Tzu Wu, of the University of Cambridge. And, project leader Andy Jones said, “We were amazed to find that dog walkers were on average more physically active and spent less time sitting on the coldest, wettest and Are you unable to work because of a severe impairment or illness? I have over 20 years experience successfully obtaining
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Protecting Chronically Ill Young People By Deborah Jeanne Sergeant
hronic illnesses in children can cost hundreds of thousands of dollars. As teens become young adults, a rite of passage necessary for chronically ill young people is transitioning to adult health coverage. Parents shouldn’t delay making their plans. Physician Tiffany Pulcino serves as medical director of Complex Care Center in Rochester, a part of the University of Rochester Medicine. Her organization helps teens starting at age 14 to develop processes for moving into the adult health system. While that may seem inordinately young, the system is so complex that the “extra” time is warranted. “They fit into a lot of gaps in the system,” Pulcino said.
The Complex Care Center offers numerous specialties — from dental to behavioral to medical health — all in one place. While that one-stopshop approach can help, providing a “safety net” for complex medical care aids young adults in monitoring their care so they don’t miss appointments or filling prescriptions. “That’s not easy for a 19-year-old with normal cognitive ability,” Pulcino said, “say nothing of one who does have delays.” Once disabled teens on Medicaid reach 19, they must re-certify as adults. The process isn’t straightforward. “People need a navigator to get through that,” Pulcino said. “Our care manager will help them with the
process. There’s support no matter where you’re touching the health care system.” She said that starting the process in advance can help improve continuity of care. Regardless of ability, young adults who are dependent upon their parents may remain on their parents’ insurance through age 26. “Work with your doctor to make a roadmap as to where you and your team want to go by the time your child is 18 years old,” Pulcino said. “Have a conversation with the care provider about critical steps to take along this path to help them be healthy when they want to reach this goal. It’s a graduation in health care to prepare for.” Lisa J. Allen, an attorney operating The Law Offices of Lisa J. Allen, PLLC, in Williamsville, knows the routine as the parent of a young person with disabilities. As for a chronically ill young person who is also cognitively disabled, she advises parents to obtain a court ruling that their 18-year-old
is an incapacitated adult so they can continue to help make decisions about health care, residence and education. For young people without a cognitive disability, they can sign a power of attorney and health care proxy to continue receiving parental help in making decisions. Otherwise, “once any child reaches 18, you have no ability to know their medical interests or their decision making,” Allen said. Without those legal instruments, the parents are left out, even if their now-adult child entirely depends upon their input for making medical choices about their care. That’s why it’s important to discuss the family’s needs with a caseworker to fully know their options and make an informed decision. The teen’s medical provider can offer recommendations on caseworkers that can help them navigate the often complex processes and make plans that work well for their family.
Financing for Those with Lifelong Special Needs By Deborah Jeanne Sergeant
t costs a lot to care for a child with special needs, especially if the child is unable to earn a full-time living as an adult. Just setting aside money isn’t always the best option. Area experts recommend a special needs trust, formally known as a supplemental needs trusts. A special needs trust can be a stand-alone piece or part of a parent’s will that takes effect after death, they say. Three types of trusts may help. The first party special needs trust involves money that is paid directly to the person with special needs, such as someone disabled in a car accident who receives a settlement. That individual (or someone legally acting on his behalf) sets up the trust and it protects their government benefits. Any funds the person doesn’t use in his life goes to the government to reimburse for any care provided. Any money left over reverts to the beneficiary who had been designated by the person with disabilities. Parents, grandparents, siblings, or anyone else can set up and fund a third party special needs trust for
disqualifies him from the SuppleHe said that it’s very easy to mental Security Income program. A include special needs trust language special needs trust safeguards access in final planning documents such as to benefits and prevents misuse of a will or trust to make it enforceable. money that should be used for life “Verbal gentleman’s agreements enhancement. are very difficult to enforce,” Lydon “A trust doesn’t replace what the said. government provides, like money for Doug Parker, certified financial food or housing,” Turoski said. “The planner and senior vice president trust can go above that housing and at Sage Rutty, Inc. in Rochester, said food to give a better quality of life that parents of a child with special the person with disabilities, but not like go on trips or going out to dinner needs “often are not prepared for the the person himself. People can fund occasionally.” situation they are in,” he said. this trust directly, with life insurance Home modifications to make the He urges clients to follow benefits upon their death, or with person’s life better may also qualify through on their planned steps to money-making assets such as rental for the use of their trust funds. protect the comfort of their loved real estate and investments. The trustee responsible for ones. Once the person with disabilities disbursing funds can be a designatParker estimated that the greatest dies, any money left reverts to the ed family member or a corporate percent of wills drafted aren’t signed family. trustee, an outside person employed and many people delay because they Cynthia Turoski, CPA and manby fees paid from the trust fund. have a few questions to answer that aging member of Bonadio Wealth “There are legal ramifications they neglect. Advisors LLC, said that a special if they misused the trust,” Turoski “I can’t tell you the number of needs trust protects people with said. “It can’t be addressed lightly. times I’ve met with clients who have special needs. It’s someone that can get professional no will or have not updated it, have Turoski said that leaving extra guidance.” not signed it or don’t have it propermoney for one of their other children A family may also appoint ly endorsed,” he said. “You have to to care for the child with disabilities co-trustees so that the corporate make intentions clear and make Nominate Us atyour www.bestoffingerla is short-sighted. Divorce, lawsuit or trustee and the family member work it easy for those who have to distribmismanagement can sap those funds. together. ute your estate.” Nominate Us at www.bestoffingerlakes.com Bonadio Wealth Advisors, LLC Trustees can change the form of He prefers clients to assign is a member of The Bonadio Group the trust fund. For example, if the co-trustees, since the family trustee and operates offices in Rochester and investment isn’t working out well, may not be capable of serving in the Nominate atfunds www.bestoffingerlakes.com other New York locations. Turoski is he could Us move the to a CD, future if the trust isn’t implemented also a certified financial planner with stocks, real estate or other asset, “as for a long time. Plus, corporate trustthe group. long as it enabled you to fulfill the ees better understand the mechanics By Sharon M. Grasta Just saving up money in the objectives of the trust: to provide for of the trust and will implement them • High-Fashion Wigs “I’d like Largest Selection of Quality child’s account won’t work, either. the beneficiary,” said Patrick D. Blends Lyproperly. • Synthetic, Human Hair wonde Wigs & Toppers in Western wig or h • Remy Human Hair Keeping more than $2,000 in a don, attorney with Sutter, Summers By Sharon M. Grasta NY for Over 50 Years!! experie • European Human Hair appoi savings account in the child’s name • Toppers come in all I Do Wig Cuts, Styles and Repairs! & Lydon,Wigs P.C. in Webster. • High-Fashion “I’d like to thank everyone for the will kno Largest Selection of Quality
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Things You Should Know About Kids’ Foot Care UR Medicine podiatrist talks about a key factor in foot care By Ernst Lamothe Jr.
our feet must last a lifetime. Most Americans log an amazing 75,000 miles on their feet by the time they reach age 50, according to the American Podiatric Medical Association. Regular foot care can make sure your feet are up to the task. With proper detection, intervention and care, most foot and ankle problems can be lessened or prevented. As kids begin to go back to school this fall, one of the family rituals is shopping for new shoes. But they should be aware that finding quality shoes is paramount proving that substance over style is the best way to go. “Not all shoes make the grade. And bad shoes are bad news for kids,” said Pearce Sloan, board-certified podiatrist for UR Medicine. “The wrong shoe can cause muscle and ligament problems, toe injuries, stress fractures and other issues. And all these problems can lead to poor posture and balance issues.” Sloan offers five tips for back to school shoe shopping for kids to get them off on the right foot.
Think about fit. Have your child’s foot measured for shoe size. They’re growing, and the shoes they wore last year needs to be replaced with a bigger size. Kids’ feet can often grow and change size every few months. in fact, if you bought cleats for your child’s spring and summer sports, they may need a larger size by the fall. “Bring your child to the store to try on shoes. Don’t assume a shoe will fit — the size of the show varies by brand and manufacturer,” said Sloan. He also suggests having your child try on both shoes and walk around in them. Check the toe area where there should be a thumb’s width of space between the big toe and tip of the shoe. Width is important too. You should be able to run a finger around the neck of the shoe. “Don’t buy over-large shoes. It’s understandable that you want to buy shoes your child can “grow into,” but shoes that are too large can affect walking, cause blisters that can lead to infection, and even cause your child to trip and fall,” added Sloan.
Avoid pointy-toed shoes. The National Institutes of Health sponsored a study of 3,300 people to find out how many experienced foot pain. The study found that roughly 28 percent of the population had chronic foot pain. Many times it is due to the shoes they select.
“Look for rounded or square toe boxes to give your child’s toes room to move. Your child’s feet may not grow properly if they don’t have enough room in their shoes,” said Sloan. In addition, he advises against heels or sandals for school wear. “Sandals don’t offer enough protection for children’s feet, and heels aren’t stable on hard school floors and can lead to falls,” he added
Check your child’s feet and their shoes for potential problems. If you’re not sure when a foot problem warrants a visit to the podiatrist, you are not alone. Many people wait a lot longer than they need to before seeing one. Consider any type of food pain a good enough reason to see a foot doctor. The same rule should apply to any unexplainable change in the aspect of your foot. “Blisters, calluses, etc., can mean they have an issue that needs attention,” said Sloan. “Check the shoe heels for uneven wear, which can signal a foot problem. Check for bulging around the toe box area, which can mean they’ve been wearing shoes that are too small.”
ant to get right, as our children are spending over 30 hours a week in them. With their feet continuously growing we need to make sure we buy our kids good supportive shoes to help shape their feet and prevent ongoing issues occurring. “Good arch support is key,” said Sloan. Laces, Velcro and buckles that enable you to adjust the fit of the shoe are a plus. Buy shoes that are ready to wear right away and don’t need to be “broken in” — shoes that are stiff can cause irritation. Poor quality shoes often are rigid and won’t fit or wear well.”
Shop smart. Look for these traits in a good shoe: • Breathable material so kids’ feet stay dry even during heavy activity • Shoes that have some “give” to accommodate movement, but still offer support in the heel and arch areas. Shoes should bend at the toe box so walking in them is comfortable, but be more solid in the arch and heel areas. Press on both sides of the back of the shoe – they shouldn’t collapse into the middle. You shouldn’t be able to twist the shoe like a rag; if you can, it won’t support the foot well enough. • Look for shoes with textured soles for secure footing on linoleum school floors.
Look for shoes that are well made and durable. School shoes are import-
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IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper
Eye Drops to Cure Cataracts? Scientists are still testing using eye drops to dissolve cataracts in humans; in the meantime, new techniques to remove them are available By Deborah Jeanne Sergeant
ore than half of people will have cataracts by age 75, according to the American Academy of Ophthalmology. Cataract surgery is a simple out patient procedure and most insurers cover it. Scientists are working on drops that seem to dissolve cataracts in animal testing; however, human trials and subsequent FDA approval are needed before it’s available to treat patients. In the meantime, cataract advances in surgical technique and materials have helped improve patients’ vision. Omar Hanuch, ophthalmologist with Cornerstone Eye Associates in Rochester, said that the procedure used to involve liquefying the lens with ultrasound waves so it could be removed through a tiny opening, “but that is more stressful for the eye because of the energy applied,” Hanuch said. Now he uses a laser from the outside that divides the cataract into very tiny pieces and make the incision over the cornea. “It’s much less traumatic and much more accurate,” he said. “It’s a big improvement for the removal of the cataract and the laser can do very precise incision. We can do it by hand
with blades, but the laser is much more accurate.” The newer lenses also help improve distance and near vision and astigmatism. According to the American Academy of Ophthalmology, 23.9 percent of the American population age 40-plus — more than 34 million — are myopic (nearsighted). Almost 14.2 million of the same age group have hyperopia (farsighted). Nearly one in three Americans has astigmatism and 150 million wear corrective eyewear. Haunch said that the newest lenses used in cataract surgery can improve vision and reduce dependency on glasses. “Until now, there were multi-focal implants that cost a lot more,” he said. “There was also more glare. With the new technology, you get the same result without the night vision problems. They work much better and are more reliable.” Scott MacRae, an ophthalmologist at UR Medicine’s Flaum Eye Institute said that the new lenses have improved the intermediate vision that previous lenses didn’t correct as well. “This lens allows patients to see that intermediate area, which is be-
As World’s Population Ages, Blindness Rates Likely to Grow
ore than 36 million people worldwide are blind, while 217 million more have moderate to severe vision loss, and experts now report that they expect those numbers to surge. By 2050, the researchers said, the number of blind people is likely to hit 115 million, with 588 million more having limited sight. The burden is greatest in developing nations, according to a study of data from 188 countries. “With the number of people with vision impairment accelerating, we must take action to increase our
current treatment efforts at global, regional and country levels,” said study lead author Rupert Bourne. He is associate director of the Vision and Eye Research Unit at Anglia Ruskin University in Great Britain. The study, published Aug. 2 in The Lancet Global Health journal, found southeast Asia has the most people who are blind. The study added that rates of blindness among older adults are highest in eastern and western sub-Saharan Africa and south Asia. The study covers 25 years — 1990 to 2015 — and offers projections
coming more and more important as people become more dependent on computers,” MacRae said. “Patients really like that.” He added that some patients subsequently undergo Lasik to clear out any residual refracting. Holly Hindman, a doctor with The Eye Care Center in Canandaigua and Geneva, said that cataract surgery is “a very safe surgery with minimal sedation,” she said. “Generally, the experience is like having your teeth cleaned.” The surgery is done in less than 15 minutes, and post-surgical eye drops are pretty easy for most patients to administer. Though patients may not lift heavy objects for a week after surgery, after that, patients can return to normal activity without restriction. “Often people want to know if the cataract grows back,” Hindman said. “It doesn’t. In 50 percent of cases, over time, like years or decades, cells can migrate across the sack that holds the lens implant. We can easily treat it with a laser. It doesn’t hurt the eye.” Clinton Sugnet, optometrist at Alexander Eye Associates in Rochester, provides pre-op and post-op for 2020 and 2050. The researchers estimate that 0.75 percent of the world’s population was blind in 1990, compared to 0.5 percent in 2015. Over the same period, the rate of moderate to severe vision loss fell from 3.8 percent to 2.9 percent. But those rates are forecast rise to 0.5 percent and 3.1 percent, respectively, by 2020. A key reason: The world’s population is getting older, and most vision loss is the result of aging. Compared to 2015, there were 5.4 million fewer blind people in 1990 and 57 million fewer with severe vision loss. The researchers described the study as the first to include figures on presbyopia, an age-related form of farsightedness that can be treated
patients. He said that very few patients aren’t good candidates for the procedure. “There’s very minimal risk for any type of complications but it is a surgery and there is a risk involved,” he said. For healthy patients, “rejection is extremely rare,” he said. “With that part of the eye and the materials used, it’s very rare to have complications, especially rejection.” With the entire population growing older and more people growing older, cataract surgery has become routine.
Preventing Cataracts So what can help prevent cataracts? Scott MacRae, ophthalmologist with UR Medicine’s Flaum Eye Institute, said that an increasing body of data indicates that eating green, leafy vegetables and other foods rich in vitamin K may reduce the likelihood of developing cataracts. with eyeglasses. More than 1 billion people over age 35 have the problem, which affects one’s ability to read. That includes 667 million people over 50. The researchers stressed the need for targeting money for treatment. They noted that between 1990 and 2010, when investments were made in vision treatment, rates of blindness fell. “Interventions for vision impairment provide some of the largest returns on investment, and are some of the most easily implemented interventions in developing regions because they are cheap, require little infrastructure and countries recover their costs as people enter back into the workforce,” Bourne said.
‘Loneliness Epidemic’ Called a Major Public Health Threat Social isolation tied to increased risk for premature death, research suggests
oneliness may be more hazardous to your health than obesity — and a growing number of Americans are at risk, researchers report. About 42.6 million American adults over age 45 are believed to suffer from chronic loneliness, according to AARP. “Being connected to others socially is widely considered a fundamental human need — crucial to both well-being and survival. Extreme examples show infants in custodial care who lack human contact fail to thrive and often die, and indeed, social isolation or soliPage 16
tary confinement has been used as a form of punishment,” said Julianne Holt-Lunstad. She is a professor of psychology at Brigham Young University in Provo, Utah. “Yet an increasing portion of the U.S. population now experiences isolation regularly,” she added during a recent presentation at the annual meeting of the American Psychological Association (APA) in Washington, D.C. Holt-Lunstad presented results of two large analyses. In one, researchers analyzed 148 studies that included a total of more than 300,000 people. Those studies linked great-
er social connection to a 50 percent lower risk of early death. The researchers also reviewed 70 studies involving more than 3.4 million people to gauge the impact of social isolation, loneliness and living alone on the risk of premature death. The conclusion: The effect of the three was equal to or greater than well-known risk factors such as obesity. More than one in four Americans lives alone, more than half are unmarried, and marriage rates and the number of children per household are declining, according to U.S. Census data. “These trends suggest that Americans are becoming less socially connected and experiencing more loneliness,” Holt-Lunstad said in an APA news release.
IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • September 2017
She said there is strong evidence that social isolation and loneliness increase the risk of early death more than many other factors. “With an increasing aging population, the effect on public health is only anticipated to increase. Indeed, many nations around the world now suggest we are facing a ‘loneliness epidemic.’ The challenge we face now is what can be done about it,” Holt-Lunstad said. Possible solutions, she said, include getting doctors to screen patients for social isolation, and training schoolchildren in social skills. Older people should prepare for retirement socially as well as financially, she added, noting that many social ties are related to the workplace.
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By Jim Miller
Finding Help for Seniors Addicted to Opioids
Signs of Addiction Your mother may be addicted to opioids if she can’t stop herself from taking the drug, and her tolerance continues to go up. She may also be addicted if she keeps using opioids without her doctor’s consent, even if it’s causing her problems with her health, money, family or friends. If you think your mom’s addicted, ask her to see a doctor for an evaluation. Go to the family or prescribing physician, or find a specialist through the American Society of Addiction Medicine (see ASAM.org) or the American Academy of Addiction Psychiatry (AAAP.org). It’s also important to be positive and encouraging. Addiction is a medical matter, not a character flaw. Repeated use of
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Concerned Daughter Dear Concerned,
The main reason opioid addiction has become such a problem for people over age 50 is because over the past two decades, opioids have become a commonly prescribed (and often overprescribed) medication by doctors for all different types of pain like arthritis, cancer, neurological diseases and other illnesses that become more common in later life. Nearly one-third of all Medicare patients — almost 12 million people — were prescribed opioid painkillers by their physicians in 2015. That same year, 2.7 million Americans over age 50 abused painkillers. Taken as directed, opioids can manage pain effectively when used for a short amount of time. But with long-term use, people need to be screened and monitored because around 5 percent of those treated will develop an addiction disorder and abuse the drugs.
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I’m worried about my 72-year-old mother who has been taking the opioid medication Vicodin for her hip and back pain for more than a year. I fear she’s becoming addicted to the drug but I don’t know what to do.
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Dear Savvy Senior,
The opioid epidemic is a national problem that is hitting people of all ages, including millions of older Americans. Here’s what you should know and do to help your mother.
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opioids actually changes the brain.
Treatments Treatment for opioid addiction is different for each person, but the main goal is to help your mom stop using the drug and avoid using it again in the future. To help her stop using the drug, her doctor can prescribe certain medicines to help relieve her withdrawal symptoms and control her cravings. These medicines include methadone (often used to treat heroin addiction), buprenorphine and naltrexone. After detox, behavioral treatments such as individual counseling, group or family counseling, and cognitive therapy can help her learn how to manage depression, avoid the drug, deal with cravings, and heal damaged relationships. For assistance, call the Substance Abuse and Mental Health Services Administration confidential help line at 800-662-4357, or see SAMHSA.gov. They can connect you with treatment services in your state that can help your mom. Also, if you find that your mom has a doctor who prescribes opioids in excess or without legitimate reason, you should report him or her to your state medical board, which licenses physicians. For contact information visit FSMB.org. Send your senior questions to: Savvy Senior, P.O. Box 5443, Norman, OK 73070, or visit www.savvysenior. org. Jim Miller is a contributor to the NBC Today show and author of “The Savvy Senior” book. September 2017 •
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IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper
Ask St. Ann’s
By Diane Kane, M.D.
Symptom or Side Effect? Multi medications can cause confusion in elderly
s we reach age 65, our risk of getting dementia increases. Of course not everyone gets dementia, but the increased risk is a natural part of aging. Yet when older adults take multiple medications, they may experience adverse, dementia-like symptoms such as memory impairment, confusion and hallucinations. When these symptoms appear, anticholinergic medications may be the culprit. Anticholinergic medications block the activity of a neurotransmitter in the brain (acetylcholine) that helps nerve impulses pass through the body. This can trigger an increase in dementia-like symptoms. These medications include many prescription and over-the-counter drugs, as well as herbal supplements. Older adults can be affected by even a low level of anticholinergics in their system. That’s why education and self-advocacy are important when it comes to selecting the right medications. Medications with a medium to high anticholinergic load include:
• Doxepin • Paxil
• Chlorphenamine (Chlor-Trimeton) • Diphenhydramine (Benadryl) • Meclizine (Antivert, Dramamine)
Overactive Bladder (OAB)
• Detrol • Ditropan • Enablex
• Zyprexa • Seroquel
The neutralizing effect
When added to an older adult’s health care regimen, anticholinergic medications can negate the impact of other meds. For example, the anti-depressant Paxil has a high anticholinergic load which can bring about the very condition the drug is supposed to treat. An alternative medication with a lower anticholinergic load, such as Zoloft, can be a better choice. Even over-the-counter medications can have an impact. For example, many sleep products (such as Tylenol PM) contain Benadryl, a common anticholinergic agent.
Though there are medicines and supplements with low anticholinergic properties, even a little may still be too much for an older adult. And taking more than one low anticholinergic at a time creates an additive effect. For example, taking Zoloft for depression, Trazodone for insomnia, and Xanax for anxiety at the same time will result in a high anticholinergic load.
hallucinations Full as a flask: Urinary retention If you are elderly or care for someone who is, be sure to check with your physician or pharmacist before adding a new medication, even an over-the-counter drug or herbal supplement, to a medication regimen. This simple step can help you avoid the adverse side effects caused by a high or additive anticholinergic load and stay as healthy as possible!
In addition to dementia-like side effects from a high anticholinergic load, other adverse side effects are worth noting — these can be an indication that a change in medications may be in order. The following memory aids (which every physician learns in med school) can help you identify them: Red as a beet: Flushed skin Dry as a bone: Impaired sweating Hot as a hare: Increased body temperature due to impaired sweating Blind as a bat: Blurred vision Mad as a hatter: Delirium and
Physician Diane Kane is chief medical officer at St. Ann’s Community. She is board-certified in internal medicine, geriatrics, hospice and palliative medicine and has been involved in senior care for 29 years. Contact her at firstname.lastname@example.org or visit www.stannscommunity.com.
The additive effect
Look for side effects
IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • September 2017
The Social Security Office
From the Social Security District Office
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2650 Lake Avenue Rochester, New York 14612 Phone: 585-428-7775 n www.cityofrochester.gov/riverside
Get to Know Your Social Security
ocial Security touches the lives of nearly every American. We’ve been with you from day one, when your parents applied for your Social Security number, and we are with you from your first job through your retirement party and beyond. For more than 80 years, Social Security has stayed true to its mission of providing financial protection for the American people and has served as one of the most successful anti-poverty programs in our nation’s history. We encourage everyone to take steps toward their financial security. Regardless of your age or place in life, now is the right time to start planning for a financially secure future for you and your family. Everyone can benefit from our first step: Get to know your Social Security. You can start your journey through all things Social Security by visiting www.socialsecurity.gov and navigating through our menu. Along the way, you’ll see how your Social Security number opens many important doors throughout life, from making it easier to apply for student aid and open your first bank account to starting your first job and buying your first house. You’ll also discover how your contributions
Q: Can I get a new Social Security number if someone has stolen my identity? A: We do not routinely assign a new number to someone whose identity has been stolen. Only as a last resort should you consider requesting a new Social Security number. Changing your number may adversely affect your ability to interact with federal and state agencies, employers and others. This is because your financial, medical, employment and other records will be under your former Social Security number. We cannot guarantee that a new number will solve your problem. To learn more about your Social Security card and number, read our online publication on the subject at www.socialsecurity.gov/pubs/10002. html. Q: I’m trying to decide when to retire. Can Social Security help? A: Deciding when to retire is a personal choice, and you should consider a number of factors, but we can certainly help. First, take a few minutes and open a “my Social Security” account at www.socialsecurity.gov/myaccount. With a “my Social Security” account, you can
to the Social Security system through FICA payroll taxes can make you eligible for important future benefits when you reach retirement age or if you become severely injured or ill. You’ll find how Social Security helps your family in the form of survivor benefits and how our Supplemental Security Income program assists disabled children and our most vulnerable adults. We also encourage you to visit our website and set up your own “my Social Security” account today so you can begin taking steps toward financial security. Through our website and your online account with us, you can: • Verify your lifetime earnings record to ensure you’re getting credit for all your contributions toward Social Security and Medicare; • Estimate future benefits for you and your family; • Manage your Social Security benefits and personal information; and • Learn more about how we’re securing your today and tomorrow. Now that you’ve started to get to know your Social Security, stay in touch by visiting our Social Security Matters blog at blog.ssa.gov/. We encourage you to visit us at www.socialsecurity.gov.
access your Social Security statement and estimate your retirement benefits at age 62, your full retirement age, and age 70. Also, we have several online calculators that can help you decide when to retire. Our retirement estimator gives estimates based on your actual Social Security earnings record. You can use the retirement estimator if: • You currently have enough Social Security credits to qualify for benefits; and • You are not: – Currently receiving monthly benefits on your own Social Security record; – Age 62 or older and receiving monthly benefits on another Social Security record; or – Eligible for a pension based on work not covered by Social Security. You can find our retirement estimator at www.socialsecurity. gov/estimator. Also available at www.socialsecurity.gov/planners/ benefitcalculators.htm are several other calculators that will show your retirement benefits as well as estimates of your disability and survivor benefit if you become disabled or die. You may want to read or listen to our publication, “When To Start Receiving Retirement Benefits,” available at www.socialsecurity.gov/pubs. September 2017 •
Is Your Medicine Safe at Home? Only YOU Can Secure Your Rx! Help us prevent addiction, accidental poisoning & protect the environment!
MONITOR– count your medication regularly
SECURE– lock up any medication you do not want anyone to access
DISPOSE– drop off any unwanted/unused and expired medication to your local disposal site
Medication Drop Box Locations: Bristol: Town Hall
Farmington: State Troopers
Canandaigua: FLCC (Keuka Wing) The Medicine Shoppe Ontario County DMV Office Thompson Hospital (lobby) Mental Health Clinic
Clifton Springs: Hospital (Lobby) Geneva: North St. Pharmacy Police Station
Phelps: Community Center
Rushville: Village Hall
Shortsville: Red Jacket Pharmacy
Victor: Mead Square Pharmacy
Questions, please call us at 585-396-4554.
A Hurlbut hug delivers the comfort of knowing that your loved one will receive the highest level of long-term care. A hug that will help to alleviate your fears. An expression of trust and confidence that everything’s going to be okay.
IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper
How to Stop Unwanted Junk Mail and Guard Against Mail Fraud By Jim Miller
Mail fraud can be tricky to detect because there are many different types of schemes out there that may seem legitimate.
illions of older Americans get bombarded with unwanted junk mail these days, including “mail fraud” schemes that people need to be particularly careful of. Here’s are some tips that may help.
Mail Fraud Alert While junk mail comes in many different forms — credit card applications, sweepstakes entries, magazine offers, coupon mailers, donation requests, political fliers, catalogs and more — the most troublesome type is mail fraud, which comes from con artists who are only trying to take your money. Mail fraud can be tricky to detect because there are many different types of schemes out there that may seem legitimate. Some of the most common mail scams targeting people today — specially seniors — are phony sweepstakes, foreign lotteries, free prize or vacation scams, fake checks (see FakeChecks.org), donation requests from charities or government agencies that don’t exist, get-rich chain
letters, work-at-home schemes, inheritance and investment scams, and many more. If your dad is getting any type of junk mail that is asking for money in exchange for free gifts or winnings, or if he’s receiving checks that require him to wire money, you need to call the U.S. Postal Inspector Service at 877-876-2455 and report it, and then throw it away. Unfortunately, once a person gets on these mail fraud lists, also known as “sucker lists,” it’s very difficult to get off. That’s because these criminals regularly trade and sell mailing lists of people who they believe to be susceptible to fraud, and they won’t remove a name when you request it. Knowing this, a good first step to help protect your dad is to alert him to the different kinds of mail fraud and what to watch for. The U.S. Postal Inspection Service can help you with this. They offer a list of the different mail fraud schemes at PostalInspectors.uspis.gov. Another option is to see if your dad would be willing to let you sort through his mail before he opens it so you can weed out the junk. You may want to have the post office
What if you could choose?
forward his mail directly to you to ensure this. If your dad feels compelled to donate to certain charities, ask him to let you check them out first to make sure they’re legitimate. You can do this at charity watchdog sites like CharityNavigator.org and Give.org.
Reduce Junk Mail While scam artists aren’t likely to
take your dad’s name off their mailing lists, most legitimate mail-order businesses will. To do this, start with the Direct Marketing Association, which offers a consumer opt-out service at DMAchoice.org. This won’t eliminate all his junk mail, but it will reduce it. The opt-out service is $2 for 10 years if you register online, or $3 by mail. Then, to put a stop to the credit card and insurance offers he gets, call the consumer credit reporting industry opt-out service at 888-567-8688, and follow the automated prompts to opt him out for either five years or permanently. Be prepared to give his Social Security number and date of birth. You can also do this online at OptOutPrescreen.com. If you choose the permanent opt-out, you’ll have to send a form in the mail. You should also make sure your dad’s home and cell phone numbers are registered with the National Do Not Call Registry (DoNotCall.gov, 888-382-1222), to help cut down on telemarketing calls.
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IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper • September 2017
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H ealth News Friendly Senior Living recognized by NRC Health Two of Friendly Senior Living’s communities, Friendly Home and Cloverwood Senior Living, have been recognized nationally by National Research Corporation, the largest source of long-term care and senior living satisfaction metrics in the nation. Friendly Home was awarded in the skilled nursing category, while Cloverwood was recognized in the independent living category. “We are honored that Cloverwood and Friendly Home made this prestigious list, both for the second time,” said Glen Cooper, president and CEO of Friendly Senior Living. “Each day, we strive to achieve excellence in all that we do, and this award reflects our commitment to providing the very best customer service to our residents, members and their families. This award is a testament to our team’s dedication, commitment and genuine compassion. I want to thank our team members for showing that friends care — always.” Both organizations received the Excellence in Action award, an honor that recognizes senior living organizations that achieve the highest levels of satisfaction excellence, as demonstrated by overall resident scores. The awards are presented to organizations that scored in the top 10 percent of qualifying independent living communities and the top 20 percent of skilled nursing providers based on responses to a key customer satisfaction survey question: Would you recommend this as a place to live to your friends and family?
Brian Heppard joins St. Ann’s medical team Physician Brian Heppard has recently joined the medical team at St. Ann’s Community, Rochester’s leading senior housing and health services provider “Dr. Heppard has been caring for older adults across Upstate New York for more than 20 years. His knowledge of geriatric medicine and expertise in senior health care has earned him the respect of patients and peers alike,” said physician Kim Petrone, St. Heppard Ann’s Community’s medical director. “We welcome him to St. Ann’s Community, where he will be an integral member of our care team.” Heppard provides outpatient care for seniors in assisted living and independent living through the private practice, Pillar Medical Associates, PC. He also provides care for residents on the ninth floor of St. Ann’s Home. He is board-certified in family medicine, geriatrics, and hospice and palliative care. He earned his medical degree from the Robert Wood
New York Chiropractic College President Frank J. Nicchi, who has been with the college since 1980, and has served as president since 2000, gives his final speech as president during a recent commencement ceremony in Seneca Falls. He retired Aug. 31. NYCC Holds Commencement medicine (MSAOM) programs; 67 from the Master of Science in for Five Degree Programs Applied Clinical Nutrition (MSACN), two of whom are dual graduates New York Chiropractic College from the DC program; one from held commencement exercises the Master of Science in Diagnostic July 29, conferring degrees on 146 Imaging (MSDI) residency; and 29 candidates: 31 from the Doctor from the Master of Science in Human of Chiropractic (DC) program; Anatomy and Physiology Instruction 18 from the Master of Science in (MSHAPI) program. Acupuncture (MSA) and Master of Graduating students attended Science in Acupuncture and Oriental from California, Colorado, Florida, Johnson Medical School and did his fellowship in geriatrics at the University of Rochester. A resident of Penfield, Heppard previously served as senior medical director for Optum-United Health Group and as vice president of medical services at Jewish Senior Life in Rochester, where he founded the area’s only physician house calls practice. That distinction earned him the Health Care Achievement Award from the Rochester Business Journal in 2010. St. Ann’s Community offers a continuum of care that includes independent retirement living, assisted living, skilled nursing, memory care, short-term transitional care, palliative care, and adult day programs. One of the area’s largest private employers, St. Ann’s employs more than 1,200 people.
Hurlbut administrator receives leadership award The American College of Health Care Administrators (ACHCA) honored Kim Danzig, administrator of The Hurlbut in Rochester, with the 2017 Eli Pick Facility Leadership Award. The leadership award was celebrated during the awards luncheon at ACHCA’s 51st Danzig Annual Convocation and Exposition in St. Louis, Mo., April 4. Fewer than 9 percent of facilities nationwide qualify. This year, 1,288 facilities met the selection criteria. Two hundred and six adminSeptember 2017 •
istrators were awarded the facility leadership award nationally. Based on the premise that facility excellence reflects leadership excellence, this award recognizes the administrator of record who provided that leadership throughout the award year. Eligibility for this award is based on three years of skilled nursing facility survey data, including the health, fire (life safety) and complaint surveys, as well as top quarter performance on designated quality measures. The criteria also include an 80 percent or greater facility occupancy and a three year avoidance of a special focus facility status. This prestigious award is made possible with the support of ABILITY Network. This award is in memory of Eli Pick who was a consummate member of ACHCA, dedicated to advancing professionalism and leadership in long term care. Founded in 1962, the American College of Health Care Administrators (ACHCA) is the only professional association devoted solely to meeting the professional needs of today’s post-acute and aging services leaders.
Highland physician assistant gets award Highland Hospital medical staff recently honored Abby McCarthy, a certified physician assistant in the department of orthopedics, with the Advanced Practice Provider of the Year award. The annual award is presented to a nurse practitioner or a physician assistant who is recognized for outstanding patient care and commitment to the mission of Highland Hospital. “Abby McCarthy is one of the best clinicians at Highland,” said
Illinois, Maryland, Massachusetts, Michigan, Minnesota, New Jersey, New York, New York City, North Dakota, Pennsylvania, Texas and Ontario, Canada. Grand marshal for the ceremony was Associate Professor Hunter Mollin. Professor Kevin Ergil was the faculty speaker; and Caitlin Atkinson, executive president of the Student Government Association, gave the student address. President Frank J. Nicchi, presiding over the final commencement before his retirement on Aug. 31, delivered the commencement address. Nicchi, who has led the NYCC since September 2000, earned his baccalaureate degree from St. John’s University in 1973, his Doctor of Chiropractic degree from New York Chiropractic College in 1978, and a Master of Science in management (with honors) at Roberts Wesleyan College in 2005. A member of the NYCC faculty since 1980, he has instructed clinical diagnosis and chiropractic technique and served as a clinician at the college’s outpatient health center in Levittown. He maintains the faculty rank of professor in the department of chiropractic clinical sciences. physician Joseph Nicholas, associate professor of medicine, University of Rochester, who nominated her for the award. “She routinely manages complex medical and surgical patients with tremendous clinical skill, and is a terrific communicator and colleague.” McCarthy, a Rochester resident, has been the lead physician assistant in orthopedics since 2013. She received her Bachelor of Science degree in physician assistant studies from Rochester Institute of Technology, and also has experience in cardiac care and emergency care. “The staff, my colleagues, and each department at Highland, have all taught me so much and afforded me every opportunity to do the best job possible,” said McCarthy. “It is a pleasure to work in this stellar environment and a bonus to be recognized with this award.”
Lifetime Care nurse is March of Dimes finalist Nurse Lauren Zwetsch has been named a 2017 March of Dimes Nurse of the Year finalist in the hospice/ home health/palliative care category. She will be recognized Sept. 22 at the annual Nurse of the Year Gala, which honors nursing excellence throughout the community. A resident of Fairport, Zwetch joined McCarthy Lifetime Care’s CompassionNet team in 2010. CompassionNet is a community-based pediatric and perinatal palliative
IN GOOD HEALTH – Rochester / Genesee Valley Healthcare Newspaper
H ealth News care program sponsored by Excellus BlueCross BlueShield. The program supports families caring for a child with a potentially life-threatening illness or expecting the birth of a child with a serious medical condition. Zwetsch holds a bachelor’s degree from Alfred State and a master’s degree in pediatric primary care from the University of Rochester. She has extensive experience in the field of pediatrics, including hematology/ oncology, child neurology and bone marrow transplant. She was nominated for this award based on her demonstrated skill and warmth in caring for children and families throughout their illnesses, most significantly, at the time of death. Lifetime Care is the Rochester/ Finger Lakes region’s largest provider of health care services at home and in home-like settings, serving more than 30,000 families each year from offices in Newark, Lakeville, Auburn, Dundee and Rochester.
naviHealth partners with MVP Health Care naviHealth, a Cardinal Health company, will now manage the full continuum of post-acute care for approximately 60,000 members enrolled in the MVP Health Care Medicare Advantage program. This new partnership aims to improve health Malko outcomes and patient satisfaction for MVP Health Care members while eliminating unnecessary medical expenses. Nationally, about 40 percent of Medicare patients discharged from a hospital are referred for post-acute care, a category that includes home health,
skilled nursing facilities, inpatient rehabilitation and long-term acute care. Of those patients, about 20 percent are readmitted to the hospital within 30 days, often an indicator of ineffective and uncoordinated care post-discharge. “When patients leave the hospital, we do everything we can to make sure they don’t need to come back,” said Clay Richards, CEO at naviHealth. “Our partnership with MVP Health Care ensures patients will get the right care in the right setting, whether they go home with nursing care or are discharged to a skilled nursing facility.” naviHealth helps patients get healthier and go home faster with a team of highly skilled, in-market clinicians who work with nurses, doctors, and other caregivers to facilitate better care, according to a company news release. The team is backed by the industry’s largest database of post-acute outcomes. Cutting-edge analytics and algorithms help these clinicians to identify outstanding
post-acute care facilities and treatment specialties at which a facility excels. naviHealth uses this data to make sure each patient gets the best treatment. “Having worked with naviHealth previously, I knew I wanted the company on my team when I moved to MVP,” said MVP Health Care Chief Medical Officer Elizabeth Malko. “It’s a high-touch, high-tech model that puts the patient at the center of every decision, and fits perfectly into our holistic approach to care.” “MVP Health Care is a forward-thinking health plan that offers innovative solutions to ensure its members receive the best care possible,” said Richards. “To have Dr. Malko, a previous client, seek us out in her new role at MVP Health Care is the highest endorsement from a health plan that already knows the importance of value-based care.”
for ingredients that can pose problems, such as caffeine and acetaminophen. “Something that says it’s safe for people with diabetes is fine, but if it
doesn’t address your symptoms, it’s not going to help you, meaning it’s medicine you don’t need,” Wilhelm said.
What Diabetics Need to Know About Over-the-Counter Meds Many cold, cough and headache remedies contain carbs, and as much alcohol as glass of beer or wine, pharmacist says
t can be tough for people with diabetes to choose appropriate over-the-counter medicines for a cold, cough or headache, a pharmacist explains. Many of these so-called OTC drugs contain carbohydrates (including sugar) that can affect blood sugar levels, or ingredients that can interact with diabetes medications, according to Miranda Wilhelm. She is a clinical associate professor at Southern Illinois University School of Pharmacy. But labels on OTC medicines don’t list carbohydrates, she said. Wilhelm presented a report on the topic at the annual meeting of the American Association of Diabetes Educators, held recently in Indianapolis. “It’s a dilemma because in some cases the carbs are so high it’s equivalent to a snack,” Wilhelm said in an association news release. “On the other hand, if you actually read the ingredients, you might be afraid to take something that’s safe and could help with symptoms. In other words, you may not be limited to OTC medicines that are formulated for people with diabetes, and that’s surprising for most people with the condition,” she said. Wilhelm offered the following
advice: • Good diabetes management is important. “If your A1C levels are well-managed and your blood pressure is at or near your goal, you should be fine taking most OTC medicines whether or not they contain carbohydrates if you just need them for a few days,” she said. • Read the label. “If you’re concerned about your blood sugar levels, look for medicines labeled ‘sugar-free’ or ‘for people with diabetes,’” Wilhem suggested. • Take pills instead of liquids. Liquid forms of medicines typically contain more carbohydrates, and sometimes as much alcohol as a glass of beer or wine, she said. • If possible, choose a “topical” medicine. The reason: They don’t get into your bloodstream. For example, a nasal spray is better for treating a stuffy nose than a medicine you take by mouth. If you have muscle pain, ice the area and use a skin cream that treats pain instead of taking Motrin, Advil (ibuprofen) or Tylenol (acetaminophen). • Get OTC recommendations from health professionals. Your doctor or pharmacist can help you avoid ingredients that would interact with your other medicines. Check labels
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